MEDICARE: MRS. KAWANYA E MUHAMMAD FNP-C

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
1	363LF0000X	Family Nurse Practitioner	71003688A	IN

General Provider Information

NPI Number	:	1043592694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAWANYA E MUHAMMAD FNP-C

Provider Business Mailing Address
First Line	:	12400 N MERIDIAN ST STE 160
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-4600
Country	:	US
Telephone Number	:	317-781-3302
Fax Number	:	317-740-1018

Provider Business Practice Location Address
First Line	:	2840 FORTUNE CIR W
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46241-5505
Country	:	US
Telephone Number	:	317-781-3302
Fax Number	:	317-740-1018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2011
Last Update Date	:	02/14/2025

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