Individual
DEBORAH KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-2345
Mailing address
10330 N MERIDIAN ST # 300, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71000455A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71000455A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200193950
—
IN
Enumeration date
11/30/2005
Last updated
10/06/2017
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