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General NPI Number Information
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NPI Number | 1003875964
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Entity Type | Individual
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Provider Name | KELLI SHEA DEMPSEY ACNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 4055 GATEWAY BLVD
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City | NEWBURGH
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State | IN
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Zip | 47630-8947
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Country | US
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Telephone | 812-842-2210
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Fax | 812-842-4599
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Provider Business Mailing Address
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Address Line | PO BOX 637273
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City | CINCINNATI
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State | OH
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Zip | 45263-7273
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Country | US
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Telephone | 812-842-2210
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Fax | 812-842-4599
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 71001008A
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License Number State | IN
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