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KELLI M BURRESS NP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1912203894

Individual Registrant:
 KELLI M BURRESS NP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1152 E US HIGHWAY 36  BAINBRIDGE, IN 46105-9604 US
Tel: 765-522-1889  Fax: 765-522-3583

Contact information for business:
1100 SOUTHFIELD DR STE 1370  PLAINFIELD, IN 46168-4300 US
Tel: 317-837-5566  Fax: 317-837-5580

Registration Information:
NPI: 1912203894
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
IN71003520A
N363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
IN71003520

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
201019020IN05




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