Individual
MRS. SANDRA KAY KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 948-7128
(317) 944-3442
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 948-7128
(317) 944-3442
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
71003101A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201079620
—
IN
Enumeration date
05/12/2010
Last updated
06/02/2021
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