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General NPI Number Information
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NPI Number | 1134014046
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Entity Type | Individual
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Provider Name | JAMIE L KENNEDY
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Gender | Female
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 1020 E 86TH ST STE 24C
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-1802
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Country | US
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Telephone | 317-641-6431
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Fax | 317-559-6778
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Provider Business Mailing Address
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Address Line | 1020 E 86TH ST STE 24C
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-1802
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Country | US
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Telephone | 317-641-6431
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Fax | 317-559-6778
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 28274522C
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License Number State | IN
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Taxonomy #6
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28274522C
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License Number State | IN
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