Bovenkerk, Kelli Joy

Bovenkerk, Kelli Joy is an individual health care provider with primary practice located at 3834 S Emerson Ave Building C, Suite 100, Indianapolis IN 46203. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Bovenkerk, Kelli Joy can be contacted via phone (775) 222-0044.

Contact Information

Primary practice address
3834 S Emerson Ave Building C, Suite 100 Indianapolis IN 46203
Phone: (775) 222-0044
Fax: (888) 700-0187
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 71006606A Indiana

Profile Details

NPI number 1285184481
LBN Legal business name Bovenkerk, Kelli Joy
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2016
Last updated Oct 3rd, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285184481 NPPES
Indiana MEDICAID 201398720

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