Healthcare Provider Details

I. General information

NPI: 1306569546
Provider Name (Legal Business Name): INTEGUMED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 E SOUTHWAY BLVD
KOKOMO IN
46902-3650
US

IV. Provider business mailing address

12315 HANCOCK ST STE 24
CARMEL IN
46032-5885
US

V. Phone/Fax

Practice location:
  • Phone: 765-485-1814
  • Fax: 765-316-7962
Mailing address:
  • Phone: 317-708-3732
  • Fax: 888-316-7962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KELLEE E PERRY
Title or Position: OWNER
Credential: FNP
Phone: 765-251-3987