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NPI Code Detail

MEDICARE: KEOAMBI LUMPKIN

MEDICARE:   KEOAMBI  LUMPKIN
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
1163W00000XRegistered Nurse28187284AIN
23747A0650XAttendant Care Provider
33747P1801XPersonal Care Attendant
4376J00000XHomemaker
5253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1003612797
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEOAMBI LUMPKIN
Provider Business Mailing Address
First Line : 2226 BERNIE DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46229
Country : US
Telephone Number : 317-622-8422
Fax Number :
Provider Business Practice Location Address
First Line : 2226 BERNIE DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46229
Country : US
Telephone Number : 317-622-8422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2025
Last Update Date : 02/22/2025

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Directions to “ KEOAMBI LUMPKIN ” Practice Location

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