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NPI Code Detail

MEDICARE: KELLY KROL

MEDICARE: KELLY KROL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerF1215664IN

General Provider Information

NPI Number : 1033576061
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY KROL
Provider Business Mailing Address
First Line : 5514 WHIRLAWAY CIR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46237-2127
Country : US
Telephone Number : 317-701-4084
Fax Number :
Provider Business Practice Location Address
First Line : 1545 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2306
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2016
Last Update Date : 01/21/2016

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Directions to “ KELLY KROL ” Practice Location

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