Individual
KATHERINE MONICA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN/NP
Contact information
Practice address
2400 17TH ST, COLUMBUS, IN 47201-5351
(812) 376-5016
(812) 376-5928
Mailing address
203 E MAIN ST, RICHMOND, IN 47374-4208
(765) 973-9294
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
28122181A
IN
363LF0000X
Family Nurse Practitioner
Primary
71000702A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200165720
—
IN
05
—
200165720A
—
IN
Enumeration date
06/15/2006
Last updated
09/06/2024
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