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DEAN M KELLY ANP

Nursing Yellow Pages

Lafayette, Indiana

Provider NPI: 1639209174

Provider Information:
 DEAN M KELLY ANP


Practice Location:
3218 DAUGHERTY DR STE 140  LAFAYETTE, IN 47909 US
Tel: 765-502-4190  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LX0106XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Occupational Health
IN71000948B

Other Provider Identifiers:

IssuerNumberStateType
ANTHEM000000599883IN01
ANTHEM000000625966IN01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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