Kelly, Katherine Joann

Kelly, Katherine Joann is an individual health care provider with primary practice located at 5165 Mccarty Ln , Lafayette IN 47905-8764. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Kelly, Katherine Joann can be contacted via phone (765) 448-8000.

Contact Information

Primary practice address
5165 Mccarty Ln Lafayette IN 47905-8764
Phone: (765) 448-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 71014151A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 71014151A Indiana

Profile Details

NPI number 1750062410
LBN Legal business name Kelly, Katherine Joann
Credentials AGACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2023
Last updated Mar 11th, 2024 - about 6 months 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 1750062410 NPPES
Indiana MEDICAID 300081318
Indiana Other Q00651574
Indiana Other 815500590

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