Individual
MALLORY KAYDEE ELLER-LEAHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
8333 NAAB RD STE 420, INDIANAPOLIS, IN 46260-1992
(317) 338-6666
Mailing address
8333 NAAB RD STE 420, INDIANAPOLIS, IN 46260-1992
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28240957A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71015946A
IN
363LG0600X
Gerontology Nurse Practitioner
71015946A
IN
Other
Enumeration date
09/04/2023
Last updated
02/12/2025
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