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General NPI Number Information
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NPI Number | 1720405087
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Entity Type | Individual
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Provider Name | KATHERINE NOLAN LU MD
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Gender | Female
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 1601 LAFAYETTE RD STE 100
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-1032
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Country | US
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Telephone | 765-362-1212
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Fax | 765-361-0210
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Provider Business Mailing Address
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Address Line | PO BOX 734240
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City | CHICAGO
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State | IL
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Zip | 60673-4240
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Country | US
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Telephone | 765-362-1212
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Fax | 765-361-0210
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A152052
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 01097241A
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License Number State | IN
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