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General NPI Number Information
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NPI Number | 1194333260
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Entity Type | Individual
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Provider Name | KELLY ANN FOSTER LINDGREN OD
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Gender | Female
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 1298 US 31 N
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City | GREENWOOD
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State | IN
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Zip | 46142-4501
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Country | US
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Telephone | 317-885-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 1315 N DEQUINCY ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46201-1823
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Country | US
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Telephone | 765-702-9456
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18004235A
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License Number State | IN
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