Provider Demographics
NPI:1518667872
Name:KAHLON, SIMARJIT K (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SIMARJIT
Middle Name:K
Last Name:KAHLON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7722 CENTERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46259-1485
Mailing Address - Country:US
Mailing Address - Phone:317-443-4266
Mailing Address - Fax:
Practice Address - Street 1:494 S EMERSON AVE STE I
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1914
Practice Address - Country:US
Practice Address - Phone:317-893-2884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2022137674363LF0000X
IN71013653A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN2022137674OtherANCC CERTIFICATION NUMBER