Healthcare Provider Details

I. General information

NPI: 1144227109
Provider Name (Legal Business Name): KIRSTEN A KAHLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 03/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8450 N PAYNE RD STE 100
INDIANAPOLIS IN
46268-6621
US

IV. Provider business mailing address

8840 COMMERCE PARK PL STE E
INDIANAPOLIS IN
46268-3129
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-4035
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number01069432A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: