Healthcare Provider Details
I. General information
NPI: 1992977953
Provider Name (Legal Business Name): KAREN ANN L:INDSLEY RN,MSN,CDE,CCRC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/31/2008
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1405 CLIFTON RD NE
ATLANTA GA
30322-1060
US
IV. Provider business mailing address
2015 UPPERGATE DRIVE
ATLANTA GA
30322-0001
US
V. Phone/Fax
- Phone: 770-757-0414
- Fax:
- Phone: 404-727-1098
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WD0400X |
| Taxonomy | Diabetes Educator Registered Nurse |
| License Number | RN133974 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: