Individual
KENAE ELIZABETH JUMPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10122 E 10TH ST STE 100, INDIANAPOLIS, IN 46229-2697
(317) 355-5717
(317) 898-9760
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002488A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200922520
—
IN
01
—
P01157048
RR MEDICARE PTAN
IN
Enumeration date
10/02/2007
Last updated
06/09/2021
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