Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 28078702A | IN |
NPI | 1457875965 |
---|---|
Provider Name | Ms. Kandyce Jean Curtis-Webster |
First Address | Indianapolis, IN 46202-5173 |
Second Address | Indianapolis, IN 46202-5173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2017 |
Last Update Date | 27/07/2017 |