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NPI 1821802497

NPI 1821802497 : KELLEY GRAFTON MSN, RN : MUNSTER, IN

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General NPI Number Information
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    NPI Number           |    1821802497
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    Entity Type          |    Individual 
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    Provider Name        |    KELLEY GRAFTON MSN, RN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/04/2025
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    Last Update Date     |    02/04/2025
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Provider Practice Location Address
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    Address Line         |    801 MACARTHUR BLVD STE 405 
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    City                 |    MUNSTER
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    State                |    IN
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    Zip                  |    46321-2919
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    Country              |    US
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    Telephone            |    219-836-5167
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    Fax                  |    219-836-5249
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Provider Business Mailing Address
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    Address Line         |    8558 BROADWAY 
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    City                 |    MERRILLVILLE
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    State                |    IN
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    Zip                  |    46410-7032
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    Country              |    US
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    Telephone            |    219-392-7084
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    Fax                  |    219-703-6854
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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        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    28243868A
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    License Number State |    IN
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