Individual
KELLY SUE JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1801 N SENATE BLVD, INDIANAPOLIS, IN 46202-1228
(317) 963-1010
(317) 962-0853
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10001755A
IL
363AM0700X
Medical Physician Assistant
Primary
100011755A
IN
Other
Enumeration date
10/31/2014
Last updated
09/02/2021
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