Individual
HOLLY KINGERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
17600 SHAMROCK BLVD, WESTFIELD, IN 46074-7002
(317) 214-5468
(317) 214-5469
Mailing address
PO BOX 843022, KANSAS CITY, MO 64184-3022
(317) 770-6900
(317) 770-6911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002749A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300029147
—
IN
Enumeration date
06/07/2019
Last updated
10/11/2024
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