Individual
KELLY MAUREEN JASKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
705 RILEY HOSPITAL DRIVE, INDIANAPOLIS, IN 46037
(317) 944-4093
(317) 944-3939
Mailing address
705 RILEY HOSPITAL DRIVE, RM 1960, INDIANAPOLIS, IN 46037
(317) 944-4093
(317) 944-3939
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003371A
IN
363LP0200X
Pediatric Nurse Practitioner
71003371A
IN
Other
Enumeration date
10/04/2010
Last updated
09/28/2012
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