Individual
KELSEA M ICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1120 SOUTH DR, FH 204, INDIANAPOLIS, IN 46202-5135
(317) 274-0275
(317) 274-0256
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71007039A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001140310
ANTHEM PTAN
IN
01
—
1659805646
ANTHEM PTAN
IN
05
—
300002112
—
IN
Enumeration date
04/17/2017
Last updated
01/06/2025
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