Individual
HOLLY R. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2855 MILLER DR STE 121B, PLYMOUTH, IN 46563-8091
(574) 522-0265
(574) 406-0025
Mailing address
211 N EDDY ST, SOUTH BEND, IN 46617-2808
(574) 237-9231
(574) 204-6355
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71004121A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201092360
—
IN
Enumeration date
09/06/2012
Last updated
05/14/2026
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