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NPI Code Detail

MEDICARE: MRS. JULIE K KORTH CPNP

MEDICARE: MRS. JULIE K KORTH CPNP
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
1363L00000XNurse Practitioner71004887AIN

General Provider Information

NPI Number : 1588081293
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JULIE K KORTH CPNP
Provider Business Mailing Address
First Line : 3400 LAFAYETTE ROAD
Second Line : SUITE 200
City : INDIANAPOLIS
State : IN
Zip : 46222-1147
Country : US
Telephone Number : 317-291-7422
Fax Number : 317-291-7433
Provider Business Practice Location Address
First Line : 3400 LAFAYETTE ROAD
Second Line : SUITE 200
City : INDIANAPOLIS
State : IN
Zip : 46222-1147
Country : US
Telephone Number : 317-291-7422
Fax Number : 317-291-7433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2014
Last Update Date : 02/09/2015

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