Individual
KELLIE ANN KILRAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
3118 S LAFOUNTAIN ST, KOKOMO, IN 46902-3710
(765) 864-4160
(844) 397-1312
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1335
(844) 397-1311
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71004200A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201166040
—
IN
Enumeration date
09/23/2012
Last updated
01/24/2023
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