Individual
MEREDITH SUSANNE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5256 E 65TH ST, INDIANAPOLIS, IN 46220-4819
(317) 429-0120
(866) 202-5499
Mailing address
8954 GLASS CHIMNEY LN, FISHERS, IN 46037-9438
(317) 501-0641
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
71008472A
IN
363LP2300X
Primary Care Nurse Practitioner
Primary
71008472A
IN
Other
Enumeration date
10/12/2018
Last updated
07/03/2019
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