Individual
KELSEA JO LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 274-0275
(317) 274-0256
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28215728A
IN
367500000X
Certified Registered Nurse Anesthetist
AC003795
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300076762
—
IN
Enumeration date
05/25/2021
Last updated
12/05/2024
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