Individual
KATELIN SULLIVAN BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8433 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2193
(317) 583-7600
Mailing address
8433 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2193
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10001211A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000682458
ANTHEM
IN
Enumeration date
09/15/2010
Last updated
07/06/2023
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