Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 28202776A | IN |
NPI | 1023466877 |
---|---|
Provider Name | Annette Kay Kleinhenz |
First Address | Columbus, IN 47201-5049 |
Second Address | Indianapolis, IN 46227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2016 |
Last Update Date | 01/06/2016 |