Individual
KEELY ANNE RADOSEVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1270 N POST RD STE A, INDIANAPOLIS, IN 46219-4254
(317) 895-6095
(317) 895-6195
Mailing address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 807-1262
(317) 859-4269
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28198674A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487680518
GROUP NPI
IN
01
—
677730
GROUP PTAN
IN
Enumeration date
05/11/2017
Last updated
01/19/2024
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