MEDICARE: KEEWANNA HALL

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1740141563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEEWANNA HALL

Provider Business Mailing Address
First Line	:	3703 WHISTLEWOOD LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-1493
Country	:	US
Telephone Number	:	463-296-8765
Fax Number	:

Provider Business Practice Location Address
First Line	:	3703 WHISTLEWOOD LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-1493
Country	:	US
Telephone Number	:	463-296-8765
Fax Number	:

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

Provider Enumeration Date	:	11/20/2025
Last Update Date	:	01/11/2026

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Directions to “ KEEWANNA HALL ” Practice Location

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