Boyer, Kelly Jo

Boyer, Kelly Jo is an individual health care provider with primary practice located at 1004 Parkway Ave Suite C, Elkhart IN 46516-9326. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Boyer, Kelly Jo can be contacted via phone (574) 294-1883.

Contact Information

Primary practice address
1004 Parkway Ave Suite C Elkhart IN 46516-9326
Phone: (574) 294-1883
Fax: (574) 295-1749
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71001272A Indiana

Profile Details

NPI number 1962462689
LBN Legal business name Boyer, Kelly Jo
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2006
Last updated Feb 12th, 2015 - about 11 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 1962462689 NPPES
Indiana MEDICAID 200313030

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