Individual
HOPE E. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
601 STATE ROUTE 664 N, LOGAN, OH 43138-8541
(740) 380-8000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0035186
OH
363LF0000X
Family Nurse Practitioner
71004148A
IN
363LF0000X
Family Nurse Practitioner
COA.13190
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000785263
ANTHEM BLUE CROSS BLUE SHIELD
—
05
—
0062692
—
OH
05
—
201107000
—
IN
Enumeration date
03/21/2012
Last updated
03/08/2024
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