Provider Demographics
NPI:1083755979
Name:KAY, SANDRA K (RN, NP)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:K
Last Name:KAY
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8333 NAAB RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5924
Mailing Address - Country:US
Mailing Address - Phone:317-396-1300
Mailing Address - Fax:317-396-1346
Practice Address - Street 1:1801 N SENATE BLVD
Practice Address - Street 2:SUITE 535
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1228
Practice Address - Country:US
Practice Address - Phone:317-396-1300
Practice Address - Fax:317-396-1346
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001550A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200215550Medicaid
IN0000641551OtherANTHEM BLUE CROSS AND BLUE SHIELD
Q26533Medicare UPIN
IN200215550Medicaid