Provider Demographics
NPI:1679008890
Name:BONFILS, KELSEY A (MS)
Entity Type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:A
Last Name:BONFILS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12023 COLBARN DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-1339
Mailing Address - Country:US
Mailing Address - Phone:317-363-6306
Mailing Address - Fax:
Practice Address - Street 1:12023 COLBARN DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-1339
Practice Address - Country:US
Practice Address - Phone:317-363-6306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program