Individual
GWENDA KELTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6800 MOON CT, TERRE HAUTE, IN 47805-1277
(812) 239-6713
Mailing address
6800 MOON CT, TERRE HAUTE, IN 47805-1277
(812) 239-6713
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28123433A
IN
163WM0102X
Maternal Newborn Registered Nurse
28123433A
IN
163WN0002X
Neonatal Intensive Care Registered Nurse
28123433A
IN
163WN0003X
Low-Risk Neonatal Registered Nurse
28123433A
IN
163WN1003X
Nutrition Support Registered Nurse
28123433A
IN
Other
Enumeration date
02/26/2022
Last updated
02/26/2022
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