Healthcare Provider Details

I. General information

NPI: 1720308430
Provider Name (Legal Business Name): SHAHLINI KAY MCKINLEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 04/14/2024
Certification Date: 04/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 ARUNDEL LN
INDIANAPOLIS IN
46222-1815
US

IV. Provider business mailing address

3140 ARUNDEL LN
INDIANAPOLIS IN
46222-1815
US

V. Phone/Fax

Practice location:
  • Phone: 317-449-9704
  • Fax: 317-534-3159
Mailing address:
  • Phone: 317-439-9207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number28146540A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71012106A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number71012106A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: