Healthcare Provider Details

I. General information

NPI: 1265356943
Provider Name (Legal Business Name): CAROLINE KLINGBEIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1701 S CREASY LN
LAFAYETTE IN
47905-4972
US

IV. Provider business mailing address

3562 WHIRLWIND WAY APT 202
LAFAYETTE IN
47909-4091
US

V. Phone/Fax

Practice location:
  • Phone: 765-502-4750
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License Number28218383A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: