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General NPI Number Information
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NPI Number | 1144984618
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Entity Type | Individual
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Provider Name | KATHLEEN ANN SIEVERT FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/29/2021
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 40 N RANGELINE RD
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City | CARMEL
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State | IN
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Zip | 46032-1741
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Country | US
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Telephone | 317-989-8463
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Fax |
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Provider Business Mailing Address
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Address Line | 12030 ZIRCON LN UNIT 300
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City | FISHERS
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State | IN
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Zip | 46038-5446
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Country | US
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Telephone | 219-422-2042
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71012326A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 28236339A
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License Number State | IN
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