Individual
MS. KAITLYN M ALPHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1801 N SENATE BLVD STE 635, INDIANAPOLIS, IN 46202-1212
(317) 963-1400
(317) 962-2595
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
28217047A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71009401A
IN
Other
Enumeration date
08/07/2019
Last updated
11/19/2020
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