Individual
REBECCA H KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7250 CLEARVISTA DR, SUITE 327A, INDIANAPOLIS, IN 46256-4692
(317) 621-7390
(317) 621-4494
Mailing address
7250 CLEARVISTA DR, SUITE 327A, INDIANAPOLIS, IN 46256-4692
(317) 621-7390
(317) 621-4494
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
01028621A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000809673
ANTHEM
IN
01
—
000000810128
ANTHEM
IN
01
—
4352781
AETNA BEHAVIORAL HEALTH
IN
Enumeration date
09/14/2006
Last updated
07/01/2015
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