Provider Demographics
NPI:1023466877
Name:KLEINHENZ, ANNETTE KAY (RN, MSN, PMH-NP)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:KAY
Last Name:KLEINHENZ
Suffix:
Gender:F
Credentials:RN, MSN, PMH-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 N 500 W
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-5049
Mailing Address - Country:US
Mailing Address - Phone:812-344-1588
Mailing Address - Fax:
Practice Address - Street 1:8320 MADISON AVENUE
Practice Address - Street 2:ADULT & CHILD MENTAL HEALTH CENTER
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227
Practice Address - Country:US
Practice Address - Phone:317-412-7489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28202776A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health