Provider Demographics
NPI:1134191679
Name:ORBAUGH, KRISTI K (NP)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:K
Last Name:ORBAUGH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:K
Other - Last Name:NASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7979 N SHADELAND AVE
Practice Address - Street 2:STE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2042
Practice Address - Country:US
Practice Address - Phone:317-621-4300
Practice Address - Fax:317-621-4301
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000036A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00452367OtherMEDICARE RR
INP01751210OtherRR MEDICARE
IN000000328310OtherANTHEM PIN (QOC)
IN000000379921OtherANTHEM PIN (ICCC)
IN000000523862OtherANTHEM PIN (CHOP)
IN100475280Medicaid
INS53544Medicare UPIN
INP01751210OtherRR MEDICARE
IN114620QQMedicare PIN
INP00452367OtherMEDICARE RR
IN000000328310OtherANTHEM PIN (QOC)
IN217760CMedicare PIN