White, Kelsey S

White, Kelsey S is an individual health care provider with primary practice located at 1111 Ronald Reagan Pkwy B1321, Avon IN 46123-7085. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. White, Kelsey S can be contacted via phone (317) 217-3300.

Contact Information

Primary practice address
1111 Ronald Reagan Pkwy B1321 Avon IN 46123-7085
Phone: (317) 217-3300
Fax: (317) 217-3474
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10002139A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 10002139A Indiana

Profile Details

NPI number 1972054708
LBN Legal business name White, Kelsey S
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2016
Last updated Jun 30th, 2023 - 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 1972054708 NPPES
Indiana Other 068010336 MEDICARE PTAN
Indiana Other 264430B03 MEDICARE PTAN
Indiana MEDICAID 300013802 MEDICARE PTAN
Indiana Other P02386895 MEDICARE PTAN
Indiana Other 267030268 MEDICARE PTAN

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