Provider Demographics
NPI:1225843873
Name:KIDWELL, AUDRIANA NICOLE (CMA)
Entity type:Individual
Prefix:MRS
First Name:AUDRIANA
Middle Name:NICOLE
Last Name:KIDWELL
Suffix:
Gender:F
Credentials:CMA
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Mailing Address - Street 1:7509 CHARLESTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47111-9623
Mailing Address - Country:US
Mailing Address - Phone:812-256-4686
Mailing Address - Fax:
Practice Address - Street 1:7509 CHARLESTOWN PIKE
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:IN
Practice Address - Zip Code:47111-9623
Practice Address - Country:US
Practice Address - Phone:812-256-4686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy