Healthcare Provider Details

I. General information

NPI: 1427348309
Provider Name (Legal Business Name): ESINATH SEKAYI KWENDA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2011
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7440 WOODLAND DR
INDIANAPOLIS IN
46278-1720
US

IV. Provider business mailing address

381 APEX DR APT 206
PLAINFIELD IN
46168-5644
US

V. Phone/Fax

Practice location:
  • Phone: 317-715-7111
  • Fax:
Mailing address:
  • Phone: 615-596-6331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number15620
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: