Healthcare Provider Details

I. General information

NPI: 1184413221
Provider Name (Legal Business Name): KATHRYN ELIZABETH DAVIS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN ELIZABETH STRAUSER

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 UNIVERSITY BLVD
INDIANAPOLIS IN
46202-5149
US

IV. Provider business mailing address

550 UNIVERSITY BLVD STE 2041
INDIANAPOLIS IN
46202-5149
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-8321
  • Fax:
Mailing address:
  • Phone: 317-944-8231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28252059A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71016553A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number09000499A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: