Individual provider · Type 1 NPI
Kelly R. Domenech, NP
Psychiatric/Mental Health Nurse Practitioner · Indianapolis, IN
NPI number
1538048376
Active
Practice location
355 W 16th St Ste 2800
Indianapolis, IN 46202-2279
Fax (317) 963-7075
Other practice locations
- 550 University Blvd, Indianapolis, IN 46202-5149 · (317) 944-5998
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | 71017023A (IN) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 71017023A (IN) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
25 other providers at this address
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About NPI 1538048376
Kelly R. Domenech, NP's National Provider Identifier is 1538048376, issued on Aug 27, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Indianapolis, IN. The record was last updated on Sep 9, 2025.