Healthcare Provider Details

I. General information

NPI: 1720695752
Provider Name (Legal Business Name): KATHRYN E HALEY AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHRYN HULL AUD

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 W 16TH ST STE 3000
INDIANAPOLIS IN
46202-2207
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-6467
  • Fax: 317-963-7085
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23002737A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: