Individual
KIERSTAN KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3920 MARIETTA CT, INDIANAPOLIS, IN 46235-1809
(317) 890-9492
Mailing address
3920 MARIETTA CT, INDIANAPOLIS, IN 46235-1809
(317) 890-9492
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA110865
IN
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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