Individual
MRS. MARLA J. KINNAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9115 HAGUE RD, INDIANAPOLIS, IN 46256-1025
(317) 521-3780
(317) 521-4435
Mailing address
8325 E SOUTHPORT RD, SUITE 100, INDIANAPOLIS, IN 46259-6805
(317) 862-6609
(317) 862-4617
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28113588A
IN
363LF0000X
Family Nurse Practitioner
Primary
71001395A
IN
Other
Enumeration date
12/02/2005
Last updated
07/25/2011
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