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Individual
KELLIE PLANCK
Active
Individual
KELLIE PLANCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71006172A
IN
363LF0000X
Family Nurse Practitioner
71006172A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000001008936
ANTHEM
IN
05
—
201358080
—
IN
Enumeration date
02/25/2016
Last updated
10/20/2020
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