Individual
KELLY J. ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, FNP-C
Contact information
Practice address
111 ARROWHEAD TRL, BEDFORD, IN 47421-5820
(812) 804-3400
Mailing address
5150 SHELBYVILLE RD, INDIANAPOLIS, IN 46237-2601
(317) 782-1577
(317) 780-5539
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003119A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201013990
—
KY
05
—
300009768
—
IN
Enumeration date
11/19/2009
Last updated
12/01/2022
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