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NPI Code Detail

MEDICARE: GRETCHEN MARY KEESLAR NP

MEDICARE: GRETCHEN MARY KEESLAR NP
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
1363L00000XNurse Practitioner28182978AIN

General Provider Information

NPI Number : 1821956855
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRETCHEN MARY KEESLAR NP
Provider Business Mailing Address
First Line : 935 HEARTHSIDE DR
Second Line :
City : BROWNSBURG
State : IN
Zip : 46112-1767
Country : US
Telephone Number : 317-496-2032
Fax Number :
Provider Business Practice Location Address
First Line : 8111 S EMERSON AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46237-8601
Country : US
Telephone Number : 317-528-5500
Fax Number : 317-528-7356
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2026
Last Update Date : 01/09/2026

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