Provider Demographics
NPI:1306590492
Name:KELLER, CHELSEA L (NP)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:L
Last Name:KELLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:L
Other - Last Name:BRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7221 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4957
Mailing Address - Country:US
Mailing Address - Phone:312-656-6043
Mailing Address - Fax:
Practice Address - Street 1:1201 N POST RD STE 4
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4225
Practice Address - Country:US
Practice Address - Phone:312-656-6043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28232407A163W00000X
IN71072439A363LP0808X
IN71012439A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health