MEDICARE: SHANA JEWELL

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	25-019814-2	IN

General Provider Information

NPI Number	:	1912842683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANA JEWELL

Provider Business Mailing Address
First Line	:	2854 HIGHLAND PL
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-5125
Country	:	US
Telephone Number	:	317-444-1682
Fax Number	:

Provider Business Practice Location Address
First Line	:	2854 HIGHLAND PL
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-5125
Country	:	US
Telephone Number	:	317-444-1682
Fax Number	:

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

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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