Provider Demographics
NPI:1639461817
Name:HEDGES, KELLEE MARIE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KELLEE
Middle Name:MARIE
Last Name:HEDGES
Suffix:
Gender:F
Credentials:FNP-BC
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Mailing Address - Street 1:611 E DOUGLAS RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-1464
Mailing Address - Country:US
Mailing Address - Phone:574-968-9100
Mailing Address - Fax:574-243-1141
Practice Address - Street 1:611 E DOUGLAS RD
Practice Address - Street 2:SUITE 108
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-1464
Practice Address - Country:US
Practice Address - Phone:574-968-9100
Practice Address - Fax:574-246-1141
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2021-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN28167458A364SM0705X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical