Individual
KELLY JO BOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1004 PARKWAY AVE, SUITE C, ELKHART, IN 46516-9326
(574) 294-1883
(574) 295-1749
Mailing address
1004 PARKWAY AVE, SUITE C, ELKHART, IN 46516-9326
(574) 294-1883
(574) 295-1749
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001272A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200313030
—
IN
Enumeration date
03/25/2006
Last updated
02/12/2015
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