Individual
MS. REBECCA KATHLEEN KELLN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 NAVARRE PL STE 5550, SOUTH BEND, IN 46601-1169
(574) 647-2550
Mailing address
3245 HEALTH DRIVE, SUITE 100, GRANGER, IN 46530-3245
(574) 647-1840
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002837A
IN
363A00000X
Physician Assistant
5601006095
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300032358
—
IN
Enumeration date
09/02/2011
Last updated
05/23/2025
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