Provider Demographics
NPI:1588405625
Name:KLEMAIER, KATELYN MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARIE
Last Name:KLEMAIER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6983 HILLSDALE CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2054
Mailing Address - Country:US
Mailing Address - Phone:317-308-2828
Mailing Address - Fax:317-576-6311
Practice Address - Street 1:8051 S EMERSON AVE STE 350
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8634
Practice Address - Country:US
Practice Address - Phone:317-308-2800
Practice Address - Fax:317-859-4040
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28259244A163W00000X
IN71015327A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300091664Medicaid