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NPI Code Detail

MEDICARE: MISS JENNIFER LYNN MCQUEEN

MEDICARE: MISS JENNIFER LYNN MCQUEEN
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
1373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1922124916
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNIFER LYNN MCQUEEN
Provider Business Mailing Address
First Line : 107 S WAYBURN ST APT B7
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46229-2994
Country : US
Telephone Number : 317-946-6659
Fax Number :
Provider Business Practice Location Address
First Line : 1350 ASHBURY DRIVE
Second Line :
City : CARMEL
State : IN
Zip : 46032-8225
Country : US
Telephone Number : 317-810-9472
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 07/08/2007

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Directions to “ MISS JENNIFER LYNN MCQUEEN ” Practice Location

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