Most Relevant Information
Provider Data
| NPI Number: | 1003392424 |
| Provider Name: | EMILY KELLY KOFFEL AGACNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | 71008313A |
Most Important Dates
| Enumeration Date: | 07/18/2018 |
| Last Updated: | 09/17/2018 |
Provider Practice Location
8330 NAAB RD STE 340
INDIANAPOLIS
IN
462602279
Practice Location Phone/Fax
| Phone: | 3173385100 |
| Fax: |
Provider Mailing Location
250 W 96TH ST # 520
INDIANAPOLIS
IN
462601316
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |