Individual
KENNEDY LAUREN STAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
5406 W 38TH ST, INDIANAPOLIS, IN 46254-2918
(317) 280-8234
Mailing address
1340 TURNER TRACE PL N, AVON, IN 46123-6869
(614) 940-6356
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004613A
IN
Other
Enumeration date
07/28/2025
Last updated
07/28/2025
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