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Individual

KIMBERLEY L JELINEK ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
5177 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71004188A
IN
363LF0000X
Family Nurse Practitioner
Primary
71004188A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001141160
ANTHEM PIN
IN
05
201114680
IN
Enumeration date
10/18/2012
Last updated
03/05/2021
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