MRS. KENNIE NICOLE JACKSON WALCOTT (NPI# 1629380316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629380316 |
| Entity Type | Individual |
| Full Name | MRS. KENNIE NICOLE JACKSON WALCOTT |
| Other Name | MRS. KENNIE NICOLE WILLIAMS |
| Practice Address |
3955 Campbell Ave Indianapolis IN 46226-4836 |
| Practice Telephone | 3173623792 |
| Mailing Telephone | 3173623792 |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2010-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 374700000X | Technician | Nursing Service Related Providers | ||
| Y | 376J00000X | Homemaker | Nursing Service Related Providers |
| Street Address |
3955 CAMPBELL AVE |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46226-4836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821300245 | Divergent Services | Voluntary or Charitable | 3955 Campbell Ave, Indianapolis, IN 46226-4836 | 2010-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053771972 | Iman Emami Ghafari | Chiropractor | 4082 Pendelton Way, Indianapolis, IN 46226 | 2016-03-04 |
| 1649649039 | Tindley Accelerated Schools | Local Education Agency (LEA) | 4625 Arlington Avenue, Indianapolis, IN 46226 | 2015-09-16 |
| 1801146261 | Strength Renewed Counseling Services | Social Worker | 5660 Caito Drive, Suite 122, Indianapolis, IN 46226 | 2012-09-13 |
| 1114122447 | Monica Beasley | Nurse's Aide | 835 Belhaven Place Apt. #3, Indianapolis, IN 46226 | 2007-06-18 |
| 1558413682 | Denise Lynne Schnell | Nurse Practitioner | 5259 N David Street, Laurence Community Wellness Center, Indianapolis, IN 46226 | 2007-01-17 |
| 1245326792 | Lina R Ealy | Specialist | 5856 Cedarstone Court, Indianapolis, IN 46226 | 2006-10-04 |
| 1740373323 | Options Treatment Acquisition Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 5602 Caito Drive, Indianapolis, IN 46226 | 2006-10-02 |
| 1518064823 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 6975 North Pendleton Pike, Indianapolis, IN 46226 | 2006-09-20 |
| 1740383454 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 5005 E 56th St, Indianapolis, IN 46226 | 2006-09-07 |
| 1164516829 | The Health and Hospital Corporation of Marion County | Pharmacy | 3840 N Sherman Dr, Indianapolis, IN 46226 | 2006-10-03 |
| Find all providers in zip 46226 | ||||
| Taxonomy Code | 376J00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Homemaker |
| An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards. |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851904098 | Mykeshia Taylor | Homemaker | 635 E 106th St, Indianapolis, IN 46280-1329 | 2020-08-27 |
| 1871106443 | Daisha Janay Hale | Homemaker | 1401 Priscilla Ave, Indianapolis, IN 46219-3213 | 2020-08-24 |
| 1073125704 | Page Wright | Homemaker | 5247 Fallwood Dr Apt 116, Indianapolis, IN 46220-5669 | 2020-08-24 |
| 1619593472 | Ashley Binion | Homemaker | 2027 Winslet Way Apt 1b, Indianapolis, IN 46217-9425 | 2020-06-17 |
| 1629616099 | Breyanna Hall | Homemaker | 6771 Stanhope Way, Indianapolis, IN 46254-9570 | 2019-12-17 |
| 1548806433 | Remarkable Touch Personal Service Company LLC | Homemaker | 8189 E 21st St Unit F, Indianapolis, IN 46219-2576 | 2019-11-26 |
| 1578114534 | Shajuan Mcfarland | Homemaker | 2356 N Oxford St, Indianapolis, IN 46218-3616 | 2019-09-21 |
| 1396397519 | Earl Bailey Jr. | Homemaker | 3537 Station St, Indianapolis, IN 46218-1459 | 2019-07-09 |
| 1649759382 | Melissa J Holder | Homemaker | 1543 Draper St, Indianapolis, IN 46203-2857 | 2018-08-13 |
| 1730693409 | Heavenly Hands Home Care LLC | Homemaker | 1243 S Centennial St, Indianapolis, IN 46241-4115 | 2017-11-16 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46226 |
Please comment or provide details below to improve the information on MRS. KENNIE NICOLE JACKSON WALCOTT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.