Healthcare Provider Details

I. General information

NPI: 1629832407
Provider Name (Legal Business Name): KIERRA HANDLON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIERRA ADAMS RN

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E RUDISILL BLVD STE 106
FORT WAYNE IN
46806-1756
US

IV. Provider business mailing address

1211 MEDICAL CENTER DR
NASHVILLE TN
37232-0004
US

V. Phone/Fax

Practice location:
  • Phone: 800-342-5653
  • Fax:
Mailing address:
  • Phone: 317-496-2608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71018544A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: