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Individual

MRS. KELLY LENTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
2732 W MICHIGAN ST, INDIANAPOLIS, IN 46222-3750
(317) 554-4600
(317) 554-4617
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71012853A
IN
363LF0000X
Family Nurse Practitioner
Primary
3015886
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3015886
STATE LICENSE
KY
01
71012853A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
06/08/2021
Last updated
09/24/2025
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