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Individual

KEVIN WHELAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2900 16TH ST, BEDFORD, IN 47421-3510
(812) 276-4378
(812) 275-1246
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28182637A
IN
367500000X
Certified Registered Nurse Anesthetist
4379A
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1102489275
ANTHEM PTAN
IN
01
1245210277
ANTHEM PTAN
IN
01
163460051
MEDICARE PTAN
IN
05
200938150
IN
01
940070019
MEDICARE PTAN
IN
Enumeration date
01/17/2006
Last updated
08/20/2024
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