Individual
KELLY NICELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 N RITTER AVE STE 410, INDIANAPOLIS, IN 46219-3046
(317) 355-2700
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28199070A
IN
363L00000X
Nurse Practitioner
Primary
71007005A
IN
Other
Enumeration date
03/09/2017
Last updated
11/27/2023
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