Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | 28217231A | IN |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 71010297A | IN |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 71010297A | IN |
NPI | 1043822844 |
---|---|
Provider Name | Kelsey M Knight |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2020 |
Last Update Date | 15/12/2021 |