Individual
KACEY NICOLE KAELIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 E 5TH ST, ANDERSON, IN 46012-3495
(765) 649-9071
Mailing address
8407 S BECKS MILL RD, SALEM, IN 47167-8174
(812) 620-3132
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000
N/A
—
Enumeration date
11/02/2020
Last updated
11/02/2020
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