Individual
KIM A DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8920 SOUTHPOINTE DR STE B, INDIANAPOLIS, IN 46227-7505
(317) 497-1900
(317) 497-1919
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28196793A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006521A
IN
Other
Enumeration date
07/29/2016
Last updated
02/06/2023
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