Individual
KELLI M BURRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1152 E US HIGHWAY 36, BAINBRIDGE, IN 46105-9604
(765) 522-1889
(765) 522-3583
Mailing address
1100 SOUTHFIELD DR STE 1370, PLAINFIELD, IN 46168-4300
(317) 837-5566
(317) 837-5580
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71003520
IN
363LF0000X
Family Nurse Practitioner
Primary
71003520A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201019020
—
IN
Enumeration date
02/10/2011
Last updated
03/03/2021
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