Kelly, Kesha Rae

Kelly, Kesha Rae is an individual health care provider with primary practice located at 8091 Township Line Rd Ste 206 , Indianapolis IN 46260-2495. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Kelly, Kesha Rae can be contacted via phone (317) 415-1000.

Contact Information

Primary practice address
8091 Township Line Rd Ste 206 Indianapolis IN 46260-2495
Phone: (317) 415-1000
Fax: (317) 415-1010
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X 71001948A Indiana

Profile Details

NPI number 1205094000
LBN Legal business name Kelly, Kesha Rae
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2008
Last updated May 5th, 2022 - about 2 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 1205094000 NPPES
Indiana MEDICAID 200540450

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