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NPI Code Detail

MEDICARE: JENNIE REBECCA LUENEBRINK

MEDICARE: JENNIE REBECCA LUENEBRINK
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
1363LF0000XFamily Nurse Practitioner71007970AIN

General Provider Information

NPI Number : 1942791058
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIE REBECCA LUENEBRINK
Provider Business Mailing Address
First Line : 3640 W 700 S
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-9340
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6125 INWOOD DR
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-5698
Country : US
Telephone Number : 812-342-5155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2018
Last Update Date : 05/24/2018

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Directions to “ JENNIE REBECCA LUENEBRINK ” Practice Location

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