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NPI Code Detail

MEDICARE: KATELYN MARIE SMITH HIS

MEDICARE: KATELYN MARIE SMITH HIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237600000XAudiologist-Hearing Aid Fitter17001692AIN

General Provider Information

NPI Number : 1164366381
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN MARIE SMITH HIS
Provider Business Mailing Address
First Line : 3843 MOLLER RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46254-2930
Country : US
Telephone Number : 317-291-3376
Fax Number : 317-291-3746
Provider Business Practice Location Address
First Line : 3843 MOLLER RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46254-2930
Country : US
Telephone Number : 317-291-3376
Fax Number : 317-291-3746
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2026
Last Update Date : 04/17/2026

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Directions to “ KATELYN MARIE SMITH HIS” Practice Location

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