Individual
KELLI A HERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1205 HADLEY RD STE 120, MOORESVILLE, IN 46158-1934
(317) 834-8960
(317) 834-8951
Mailing address
PO BOX 781076, DETROIT, MI 48278-1008
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01057454
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200427150A
—
IN
05
—
64069651
—
KY
Enumeration date
07/04/2006
Last updated
01/16/2026
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