Individual
KELLY E MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11020 PENDLETON PIKE, INDIANAPOLIS, IN 46236-2817
(317) 826-3903
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28199136A
IN
363L00000X
Nurse Practitioner
Primary
7100732A
IN
Other
Enumeration date
05/10/2017
Last updated
11/27/2023
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