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General NPI Number Information
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NPI Number | 1669182085
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Entity Type | Organization
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Legal Business Name | MCKINLEY ROUNDING PROVIDERS LLC
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Dates
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Enumeration Date | 11/28/2022
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 4954 E 56TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-5773
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Country | US
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Telephone | 800-561-2078
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Fax | 317-388-5655
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Provider Business Mailing Address
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Address Line | 3140 ARUNDEL LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46222-1815
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Country | US
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Telephone | 317-439-9207
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | SHAHLINI KAYE MCKINLEY
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Credential | NP
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Telephone | 317-439-9207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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