MEDICARE: MIAUNA KINNARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	171400000X	Health & Wellness Coach
2	174H00000X	Health Educator
3	171M00000X	Case Manager/Care Coordinator	KY
4	372600000X	Adult Companion

General Provider Information

NPI Number	:	1912767534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIAUNA KINNARD

Provider Business Mailing Address
First Line	:	3423 STONY SPRING CIR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40220-5437
Country	:	US
Telephone Number	:	502-712-7443
Fax Number	:

Provider Business Practice Location Address
First Line	:	3423 STONY SPRING CIR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40220-5437
Country	:	US
Telephone Number	:	502-709-9589
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2024
Last Update Date	:	01/13/2026

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Directions to “ MIAUNA KINNARD ” Practice Location

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