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General NPI Number Information
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NPI Number | 1336650100
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Entity Type | Individual
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Provider Name | KIERSTEN L MCKINNEY
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Gender | Female
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Dates
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Enumeration Date | 10/19/2017
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Last Update Date | 09/21/2020
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Provider Practice Location Address
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Address Line | 865 WESTFIELD RD STE D
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City | NOBLESVILLE
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State | IN
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Zip | 46062-8938
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Country | US
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Telephone | 317-776-3851
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Fax | 317-776-3854
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Provider Business Mailing Address
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Address Line | PO BOX 775985
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City | CHICAGO
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State | IL
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Zip | 60677-5985
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Country | US
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Telephone | 317-770-6900
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Fax | 317-770-6911
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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 | 71007572A
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License Number State | IN
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