Individual
KRISTINE MELISSA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8091 TOWNSHIP LINE RD STE 105, INDIANAPOLIS, IN 46260-2495
(317) 415-8050
Mailing address
8091 TOWNSHIP LINE RD STE 105, INDIANAPOLIS, IN 46260-2495
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01066289A
IN
208000000X
Pediatrics Physician
37568
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200936470
—
IN
Enumeration date
05/20/2008
Last updated
08/09/2022
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