Provider Demographics
NPI:1740050772
Name:CALVERT, KATHY A
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:A
Last Name:CALVERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:A
Other - Last Name:CALVERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4515 PRISCILLA AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-3339
Mailing Address - Country:US
Mailing Address - Phone:317-993-6827
Mailing Address - Fax:
Practice Address - Street 1:4515 PRISCILLA AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-3339
Practice Address - Country:US
Practice Address - Phone:317-993-6827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care