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Individual

DR. KENYA EVERETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2855 N KEYSTONE AVE STE 100, INDIANAPOLIS, IN 46218-2790
(317) 957-2300
(317) 957-2320
Mailing address
3403 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
(317) 957-2000
(317) 957-2050

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01050551A
IN
207Q00000X
Family Medicine Physician
036107482
IL
207Q00000X
Family Medicine Physician
4301080824
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200291750
IN
Enumeration date
09/12/2007
Last updated
02/29/2024
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