Healthcare Provider Details

I. General information

NPI: 1902399538
Provider Name (Legal Business Name): KAILEY GREGORY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2018
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8051 S EMERSON AVE
INDIANAPOLIS IN
46237-8600
US

IV. Provider business mailing address

8051 S EMERSON AVE STE 400
INDIANAPOLIS IN
46237-8633
US

V. Phone/Fax

Practice location:
  • Phone: 317-865-3600
  • Fax:
Mailing address:
  • Phone: 317-865-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71008137A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28211631A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: