Individual
KATHERINE J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(888) 484-3258
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01052062A
IN
207RN0300X
Nephrology Physician
Primary
01052062A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200115640
—
IN
Enumeration date
04/19/2006
Last updated
03/13/2025
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