Individual
KASEY L ELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2525 W UNIVERSITY AVE, MUNCIE, IN 47303-3421
(765) 289-6381
Mailing address
1200 W WHITE RIVER BLVD, RCS PROVIDER ENROLLMENT, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71009472A
IN
Other
Enumeration date
10/07/2019
Last updated
02/10/2021
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