Individual
JACOB FLOYD KEULTJES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, FNP-C
Contact information
Practice address
500 ARCADE AVE STE 320, ELKHART, IN 46514-2477
(574) 523-7900
(574) 523-7909
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-2713
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28215465A
IN
363LF0000X
Family Nurse Practitioner
Primary
71014104A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300083476
—
IN
Enumeration date
05/18/2023
Last updated
02/03/2026
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