Keller, Lacey

Keller, Lacey is an individual health care provider with primary practice located at 8075 N Shadeland Ave Ste 200, Indianapolis IN 46250-2693. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Keller, Lacey can be contacted via phone (317) 621-8640.

Contact Information

Primary practice address
8075 N Shadeland Ave Ste 200 Indianapolis IN 46250-2693
Phone: (317) 621-8640
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 28187969A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 71006524A Indiana

Profile Details

NPI number 1548713290
LBN Legal business name Keller, Lacey
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2016
Last updated Jun 15th, 2021 - about 5 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 1548713290 NPPES
Indiana MEDICAID 201399380

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