Individual
KATIE D ALDRIDGE
Active
Individual
KATIE D ALDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
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
Update your record
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