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Individual

KELSEY ANN COWDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
5908 E STOP 11 RD, INDIANAPOLIS, IN 46237-8683
(317) 497-6800
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02005823A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11020100A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
266180F58
MEDICARE INDIVIDUAL PTAN
IN
05
300014770
IN
01
Q00246517
RAILROAD MEDICARE
IN
Enumeration date
04/05/2018
Last updated
04/19/2022
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