Bovenkerk, Kelli Joy
Bovenkerk, Kelli Joy is an individual health care provider with primary practice located at 3834 S Emerson Ave Building C, Suite 100, Indianapolis IN 46203. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Bovenkerk, Kelli Joy can be contacted via phone (775) 222-0044.Contact Information
Primary practice address
3834 S Emerson Ave Building C, Suite 100
Indianapolis IN 46203
Phone: (775) 222-0044
Fax: (888) 700-0187
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 71006606A | Indiana |
Profile Details
| NPI number | 1285184481 |
|---|---|
| LBN Legal business name | Bovenkerk, Kelli Joy |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2016 |
| Last updated | Oct 3rd, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285184481 | NPPES |
| Indiana | MEDICAID | 201398720 |
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