Individual
KATIE D ALDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
253 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1501
(765) 448-8000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28212117A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71007247B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001097333
ANTHEM PROVIDER NUMBER
IN
05
—
300004829
—
IN
Enumeration date
03/15/2017
Last updated
12/09/2021
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