Individual
KELLY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
208 CORWIN LN, KOKOMO, IN 46902-6612
(765) 453-5686
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7584
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71005777A
IN
363LF0000X
Family Nurse Practitioner
F07151279
IN
Other
Enumeration date
08/24/2015
Last updated
07/21/2021
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