Individual
KELLY L. PRATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1199 HADLEY RD STE 100, MOORESVILLE, IN 46158-1788
(317) 834-3263
(317) 834-5194
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001368A
IN
Other
Enumeration date
03/10/2017
Last updated
05/30/2023
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