Individual provider · Type 1 NPI

Kelly A. Manicke, NP

Adult Health Nurse Practitioner · Indianapolis, IN

NPI number 1508015439 Active

Practice location

7250 Clearvista Dr Ste 355
Indianapolis, IN 46256-5609

Mailing address

6626 E 75th St, Suite 500
Indianapolis, IN 46250-2890

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X28164416 (IN)
Nurse Practitioner 363L00000X71002746A (IN)
Adult Health Nurse Practitioner Primary 363LA2200X71002746A (IN)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1508015439

Kelly A. Manicke, NP's National Provider Identifier is 1508015439, issued on Sep 16, 2008. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Indianapolis, IN. The record was last updated on Apr 30, 2018.