Provider Demographics
NPI:1841272440
Name:MCGILL, KARLEEN ANN (NP)
Entity type:Individual
Prefix:MRS
First Name:KARLEEN
Middle Name:ANN
Last Name:MCGILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:8012 E 10TH ST STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-5211
Practice Address - Country:US
Practice Address - Phone:317-924-8297
Practice Address - Fax:317-924-8239
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71000190A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ININ1126001OtherMEDICARE PTAN
IN050611856OtherALLERGY ASSOC TAX ID
IN35-1113767OtherMC TAX ID
ININ1127001OtherMEDICARE PTAN
DE8633OtherRAILROAD MEDICARE GROUP
ININ1125001OtherMEDICARE PTAN
DE8633OtherRAILROAD MEDICARE GROUP
INS49132Medicare UPIN