Individual
KELLY B O'SHAUGHNESSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13250 HAZEL DELL PKWY STE 104, CARMEL, IN 46033-8527
(317) 415-6900
Mailing address
13250 HAZEL DELL PKWY STE 104, CARMEL, IN 46033-8527
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71006481A
IN
363LP2300X
Primary Care Nurse Practitioner
Primary
71006481A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201385430
—
IN
Enumeration date
07/26/2016
Last updated
07/18/2023
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