Individual
KIMBERLY NEIDIGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7250 CLEARVISTA DR, SUITE 355, INDIANAPOLIS, IN 46256-0020
(317) 621-5676
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002094A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01723993
MEDICARE RAILROAD PTAN
IN
Enumeration date
07/27/2016
Last updated
12/16/2016
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