Healthcare Provider Details

I. General information

NPI: 1356777916
Provider Name (Legal Business Name): KAREN S TEN CATE RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8220 NAAB RD SUITE 102
INDIANAPOLIS IN
46260-5926
US

IV. Provider business mailing address

10330 N MERIDIAN ST STE 250
INDIANAPOLIS IN
46290-1024
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-2349
  • Fax: 317-338-2797
Mailing address:
  • Phone: 317-962-3834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number37001216A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: