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Individual

JIMMY L CHENOWITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4265 E MAIN ST, AVON, IN 46123-9174
(317) 268-6555
Mailing address
1505 CHERRY TREE RD, AVON, IN 46123-7124

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
28178114A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71012070A
IN

Other

Enumeration date
12/10/2021
Last updated
03/03/2022
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