Kelcey Granger

Individual provider Active NPI Athletic Trainer · McCordsville, IN

NPI 1700306248 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1700306248
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
10430 Austin PL
McCordsville, IN 46055-9623
Phone
(317) 435-6405
NPI assigned
Jun 26, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

10430 Austin PL
McCordsville, IN 46055-9623

Mailing address

10430 Austin PL
McCordsville, IN 46055-9623
Phone (317) 435-6405

Other identifiers

IdentifierTypeStateIssuer
390200000XOtherIN22555A2300X

Other providers in McCordsville, IN

All providers in McCordsville, IN · Athletic Trainer in Indiana

Sources for this page

Verify at the official NPI Registry.