Individual
COLLEEN BRADY KEMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-5820
(317) 962-3916
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002251A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001107187
ANTHEM PTAN
IN
05
—
300006032
—
IN
Enumeration date
09/22/2013
Last updated
02/12/2025
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