LACEY KELLER


Address: 8075 N Shadeland Ave, Ste 200, Indianapolis, IN 46250-2693
Phone: 3176218640

LACEY KELLER (NPI# 1548713290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548713290
Entity Type Individual
Full Name LACEY KELLER
Other Name LACEY WERNER
Credential NP
Practice Address 8075 N Shadeland Ave
Ste 200
Indianapolis
IN 46250-2693
Mailing Address 6626 E 75th St
Suite 500
Indianapolis
IN 46250-2805
Practice Telephone 3176218640
Enumeration Date 2016-07-29
Last Update Date 2019-05-28
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 28187969A IN Nursing Service Providers
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
71006524A IN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN 201399380 05

Office Location

Street Address 8075 N SHADELAND AVE
STE 200
City INDIANAPOLIS
State IN
Zip Code 46250-2693

Providers in the same location

NPI Name Taxonomy Address Enumeration
1922005289 Angela Kaye Unfried Physician Assistant 8075 N Shadeland Ave, Suite 120, Indianapolis, IN 46250-2693 2005-07-01
1780158352 Kay Ellen Simon Nurse Practitioner 8075 N Shadeland Ave, Indianapolis, IN 46250-2693 2019-01-17
1831667823 Jaswinder Jalf Nurse Practitioner 8075 N Shadeland Ave, Indianapolis, IN 46250-2693 2018-11-07
1588130108 Diane Marie Doty Clinical Nurse Specialist 8075 N Shadeland Ave, Indianapolis, IN 46250-2693 2018-10-22
1457887622 Kelly Ann Lowe Registered Nurse 8075 N Shadeland Ave, Indianapolis, IN 46250-2693 2017-05-10
1326480948 Kelly L Warren Registered Nurse 8075 N Shadeland Ave, Suite 200, Indianapolis, IN 46250-2693 2013-07-24
1780025247 Community Health Network General Acute Care Hospital 8075 N Shadeland Ave, Indianapolis, IN 46250-2693 2013-07-12
1780021758 Kendra Marie Storer Registered Nurse 8075 N Shadeland Ave, Suite 200, Indianapolis, IN 46250-2693 2013-05-30
1356787493 Jennifer Ruth Heisick Nurse Practitioner 8075 N Shadeland Ave, Suite 200, Indianapolis, IN 46250-2693 2013-05-16
1598018749 Nicole B Finkelmeier Physician Assistant 8075 N Shadeland Ave, Indianapolis, IN 46250-2693 2012-10-24
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861037004 Angela L Davis Pharmacist 8520 Bash St, Indianapolis, IN 46250 2019-11-12
1710455738 Physicians Wellness Associates LLC Family Medicine 4735 Statesmen Drive, Suite C, Indianapolis, IN 46250 2018-11-07
1891222584 Confidential Drug LLC Pharmacy 8520 Bash St Ste D, Indianapolis, IN 46250 2017-05-12
1659813590 Occupational Health Centers of The Southwest Pa Clinic/Center 8257 Center Run Rd, Indianapolis, IN 46250 2016-11-09
1194275669 Lucina Treatment Center, LLC Internal Medicine 8140 Castleton Rd, Indianapolis, IN 46250 2016-10-09
1609126150 Joseph Lee Deck Physical Therapist 7400 Jewel Lane, Indianapolis, IN 46250 2012-09-12
1447508254 Choices Coordinated Care Solutions, Inc. Clinic/Center 7941 Castleway Drive, Indianapolis, IN 46250 2012-08-28
1568719854 Lynda L. Blackwelder, LLC Marriage & Family Therapist 4735 Statesmen Dr., Suite A, Indianapolis, IN 46250 2012-08-06
1972859452 Courtney B. Cortez Nurse Practitioner 12400 N Meridian Ste 100, Suite 500, Indianapolis, IN 46250 2012-08-02
1861761934 Kb Medical, Inc. Durable Medical Equipment & Medical Supplies 8455, Castlewood Drive, Suite J, Idianapolis, IN 46250 2011-12-20
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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1417567249 Sarah E Munson Nurse Practitioner 1633 N Capitol Ave Ste 680, Indianapolis, IN 46202-1281 2020-08-06
1750844890 Sarah Kathleen Cherry Nurse Practitioner 4326 Maldenhair Dr, Indianapolis, IN 46239-9033 2019-04-06
1184103459 Katherine Rose Ahaus Nurse Practitioner 1801 Senate Blvd Ste 230, Indianapolis, IN 46202-1252 2018-08-08
1386197770 Masita Isabel Poray Nurse Practitioner 5435 E 16th St Ste 500, Indianapolis, IN 46218-4869 2016-08-02
1316370612 Paradigm Living Concepts, LLC Nurse Practitioner 8904 Bash St Ste B, Indianapolis, IN 46256-1286 2013-08-10
1902414709 Michelle Nicole Gibson Nurse Practitioner 1801 N Senate Blvd, Indianapolis, IN 46202-1228 2020-07-17
1467081455 Sarah Elizabeth Wheeler Nurse Practitioner 1801 N Senate Blvd Ste 635, Indianapolis, IN 46202-1212 2020-04-02
1154965531 Monica Deryckere Nurse Practitioner 8424 Naab Rd Ste 1l, Indianapolis, IN 46260-1954 2019-10-29
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Competitor

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City INDIANAPOLIS
Zip Code 46250

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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