KENNIE N JACKSON, Driver INDIANAPOLIS, IN

Contact Information

KENNIE N JACKSON

315 PALMYRA DR
INDIANAPOLIS, IN 46239-9170

Phone: 317-909-0320
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Driver	172A00000X
Adult Companion	372600000X
Homemaker	376J00000X

Indicates primary specialty

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NPI Profile & details for KENNIE N JACKSON · (Female)

NPI #	`1629380316`
Status	Active
Credentials
Entity	Individual
Enumeration date	07/09/2010
Last updated	08/19/2024 - More than a year ago
Sole proprietor ¹	No
Identifiers	IN License # 2400290281
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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