Healthcare Provider Details

I. General information

NPI: 1174405765
Provider Name (Legal Business Name): KATELYNN ZIEGLER LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11720 OLIO RD STE 400
FISHERS IN
46037-7674
US

IV. Provider business mailing address

9270 STONEBRIDGE DR APT A
INDIANAPOLIS IN
46240-4545
US

V. Phone/Fax

Practice location:
  • Phone: 765-667-6672
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT22107309
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: