Individual
KIMBERLY S HANDROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2705 N LEBANON ST STE 415, LEBANON, IN 46052-8621
(765) 485-8900
(765) 485-8909
Mailing address
2605 N LEBANON ST, LEBANON, IN 46052-1476
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28152774A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71001322A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300069096
—
IN
Enumeration date
11/06/2006
Last updated
10/11/2023
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