King, Shelly J
King, Shelly J is an individual health care provider with primary practice located at 705 Riley Hospital Dr Suite 4230, Indianapolis IN 46202-5109. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. King, Shelly J can be contacted via phone (317) 944-7411.Contact Information
Primary practice address
705 Riley Hospital Dr Suite 4230
Indianapolis IN 46202-5109
Phone: (317) 944-7411
Fax: (317) 944-7481
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 71001248A | Indiana |
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 71001248A | Indiana |
Profile Details
NPI number | 1427044874 |
---|---|
LBN Legal business name | King, Shelly J |
Credentials | Nurse Practitioner (NP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 21st, 2005 |
Last updated | Dec 17th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1427044874 | NPPES |
Indiana | MEDICAID | 200366990 | |
Indiana | Other | 000000593125 |
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