Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 01040517A | IN |
Y | 2080P0203X | Pediatric Critical Care Doctor | 01040517A | IN |
NPI | 1023092814 |
---|---|
Provider Name | Kay Annette Sichting |
First Address | Indianapolis, IN 46290-1024 |
Second Address | Indianapolis, IN 46260-1902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 02/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200206410 | (05) | IN |
F71306 | (02) |