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NPI Code Detail

MEDICARE: KACIE ELIZABETH PIEDMONTE PA-C

MEDICARE: KACIE ELIZABETH PIEDMONTE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant10002111AIN

General Provider Information

NPI Number : 1952856023
Entity Type Code : Individual
Provider Name (Legal Business Name) : KACIE ELIZABETH PIEDMONTE PA-C
Provider Business Mailing Address
First Line : 250 W 96TH ST STE 520
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-1317
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2001 W 86TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-1902
Country : US
Telephone Number : 317-338-2345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2016
Last Update Date : 03/18/2026

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Directions to “ KACIE ELIZABETH PIEDMONTE PA-C” Practice Location

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