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General NPI Number Information
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NPI Number | 1588342372
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Entity Type | Individual
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Provider Name | KENNEDY FAYE HOSTETLER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 8801 N MERIDIAN ST STE 108
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-2353
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Country | US
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Telephone | 317-846-6654
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Fax | 317-846-3038
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Provider Business Mailing Address
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Address Line | 18334 LAKE WINDS DR
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City | WESTFIELD
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State | IN
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Zip | 46074-6316
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Country | US
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Telephone | 317-879-6971
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26030336A
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License Number State | IN
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