Individual
KELLEY LYNN CARROLL
Active
Individual
KELLEY LYNN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
71000884
IN
363LF0000X
Family Nurse Practitioner
71000884
IN
Other
Enumeration date
04/25/2008
Last updated
04/25/2008
Update your record
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