Individual
KATHRYN E CALHOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 333-2663
(812) 676-4131
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-11127
NC
363A00000X
Physician Assistant
Primary
10004501A
IN
363AM0700X
Medical Physician Assistant
MA54269
PA
363AM0700X
Medical Physician Assistant
OA002432
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05032086
—
NY
01
—
12078131
CAQH
—
Enumeration date
01/18/2010
Last updated
01/15/2025
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