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NPI Code Detail

MEDICARE: KAITLIN TYNER

MEDICARE: KAITLIN TYNER
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
1235Z00000XSpeech-Language Pathologist22006609AIN
2235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1255869954
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLIN TYNER
Provider Business Mailing Address
First Line : 8350 CRAIG ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-3593
Country : US
Telephone Number : 317-578-0410
Fax Number :
Provider Business Practice Location Address
First Line : 8350 CRAIG ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-3593
Country : US
Telephone Number : 317-578-0410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2017
Last Update Date : 09/12/2025

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Directions to “ KAITLIN TYNER ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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