Rachel Christine Kelley, RDH, LDH, BSDH
Individual provider Active NPI Dental Hygienist · Burns Harbor, IN
NPI 1801614730 · NPPES record last updated Sep 30, 2024
Key facts
- NPI
- 1801614730
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 020.015634 (IL)
- Practice address
- 1151 Cessna Dr
Burns Harbor, IN 46304-8741 - Phone
- (219) 381-4306
- NPI assigned
- Sep 30, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020.015634 | IL | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 13008217A | IN | |
| Dental Hygienist | 124Q00000X | 020.015634 | IL | Yes |
Addresses
Primary practice location
1151 Cessna Dr
Burns Harbor, IN 46304-8741
Mailing address
1151 Cessna Dr
Burns Harbor, IN 46304-8741
Phone (219) 381-4306
Other providers in Burns Harbor, IN
- Jaclyn Clarke
- Jami Lynn Crisman
- Syenicka T Jackson
- Thaddeus Thomas Linen Jr.
- Shariliz Martinez
- Occupational Health Centers of the Southwest PA
- Nancy Spiegla
- Town of Burns Harbor
All providers in Burns Harbor, IN · Dental Hygienist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.