Individual provider · Type 1 NPI

Kelli Jo-Ann Bacon

General Practice Registered Nurse · Mishawaka, IN

NPI number 1558056655 Active

Practice location

1540 Trinity Pl
Mishawaka, IN 46545-5006

Specialties and licenses

TaxonomyCodeLicense
General Practice Registered Nurse Primary 163WG0000X28188683A (IN)

General Practice Registered Nurse: Definition to come...

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About NPI 1558056655

Kelli Jo-Ann Bacon's National Provider Identifier is 1558056655, issued on Apr 6, 2023. The primary taxonomy on file is General Practice Registered Nurse (163WG0000X), and the practice location is in Mishawaka, IN. The record was last updated on Apr 6, 2023.