Individual
KATHERINE ANN BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2902 W 86TH ST STE 220, INDIANAPOLIS, IN 46268-2196
(317) 343-8607
(877) 473-0054
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
28198239A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71005150A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q00416530
RAILROAD MEDICARE
IN
Enumeration date
09/15/2014
Last updated
03/04/2026
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