Healthcare Provider Details

I. General information

NPI: 1134903974
Provider Name (Legal Business Name): MARIA ELISA KATSIMPALIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N. UNIVERSITY BLVD
INDIANAPOLIS IN
46202
US

IV. Provider business mailing address

7083 MILLET LN
AVON IN
46123-9355
US

V. Phone/Fax

Practice location:
  • Phone: 317-948-8854
  • Fax: 317-222-2193
Mailing address:
  • Phone: 317-443-9106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number28222655A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: