Individual
MRS. KELLI JEANNE CARIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
406 N 1ST ST, VINCENNES, IN 47591-1340
(812) 882-4694
Mailing address
8220 S RUPPEL RD, VINCENNES, IN 47591-7672
(812) 887-8263
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28173973A
IN
363LF0000X
Family Nurse Practitioner
Primary
71010196A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71010196A
APN LICENSE
IN
01
—
71010196B
CSR
IN
Enumeration date
06/05/2020
Last updated
03/07/2023
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