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Kenedi Ellen Elizabeth Divine
Student in an Organized Health Care Education/Training Program in Jasper, Indiana
NPI 1275276560

Kenedi Ellen Elizabeth Divine is a Student in an Organized Health Care Education/Training Program based in Jasper, IN. Kenedi Ellen Elizabeth Divine practices in Jasper, IN. The NPI Number for Kenedi Ellen Elizabeth Divine is 1275276560 and holds a License No. (Indiana).

The current practice location address for Kenedi Ellen Elizabeth Divine is 996 Bartley Street, Jasper, IN and can be reached out via phone at 812-996-7810 and via fax at 812-996-8465.

Location: 996 Bartley Street, Jasper, IN, 47546-2641
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1275276560
Provider Name
Kenedi Ellen Elizabeth Divine
Credential
Provider Entity Type
Individual
Gender
Female
Address
996 Bartley Street, Jasper, IN, 47546-2641
Phone Number
812-996-7810
Fax Number
812-996-8465
Provider Enumeration Date
04/15/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
996 Bartley Street
City
Jasper
State
Indiana
Zip
47553
Phone Number
812-996-7810
Fax Number
812-996-8465
person
Provider Business Mailing Address Details
Address
996 Bartley Street
City
Jasper
State
Indiana
Zip
47553
Phone Number
812-996-7810
Fax Number
812-996-8465
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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