Losiniecki, Kelly Mae

Losiniecki, Kelly Mae is an individual health care provider with primary practice located at 211 N Eddy St. , South Bend IN 46617-3096. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Losiniecki, Kelly Mae can be contacted via phone (574) 237-9231.

Contact Information

Primary practice address
211 N Eddy St. South Bend IN 46617-3096
Phone: (574) 237-9231
Fax: (574) 204-6355
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71003885A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 28176558A Indiana

Profile Details

NPI number 1013288448
LBN Legal business name Losiniecki, Kelly Mae
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2012
Last updated Mar 7th, 2018 - about 6 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 1013288448 NPPES
Indiana Other 000000758607 BCBS BMG NORTH CENTRAL NEUROSURGERY
Indiana Other P01203728 BCBS BMG NORTH CENTRAL NEUROSURGERY
Indiana MEDICAID 201058080 BCBS BMG NORTH CENTRAL NEUROSURGERY

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