Healthcare Provider Details

I. General information

NPI: 1326959834
Provider Name (Legal Business Name): KATE HAYNES RN, CDCES, LDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 UNIVERSITY BLVD STE 2110
INDIANAPOLIS IN
46202-5149
US

IV. Provider business mailing address

550 UNIVERSITY BLVD STE 2110
INDIANAPOLIS IN
46202-5149
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-3500
  • Fax:
Mailing address:
  • Phone: 317-944-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number28217704A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: