Provider Demographics
NPI:1851155808
Name:KALK, HANNAH (PNP-AC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:KALK
Suffix:
Gender:F
Credentials:PNP-AC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:E
Other - Last Name:FENKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1078 CHAPMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-3191
Mailing Address - Country:US
Mailing Address - Phone:765-524-6489
Mailing Address - Fax:
Practice Address - Street 1:705 RILEY HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5109
Practice Address - Country:US
Practice Address - Phone:317-944-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71014936A363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics