Steven L Kenyon
Individual provider Active NPI Home Modifications Contractor · Brookston, IN
NPI 1144477753 · NPPES record last updated Aug 26, 2008
Key facts
- NPI
- 1144477753
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Modifications Contractor 171WH0202X
- License
- 200878950A (IN)
- Practice address
- 9368 S 150 W
Brookston, IN 47923-8059 - Phone
- (765) 563-6163
- NPI assigned
- Aug 26, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200878950A | IN | MD | Home Modifications Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | 200878950A | IN | Yes |
Addresses
Primary practice location
9368 S 150 W
Brookston, IN 47923-8059
Mailing address
9368 S 150 W
Brookston, IN 47923-8059
Phone (765) 563-6163
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200878950A | Medicaid | IN |
Other providers in Brookston, IN
- Artha Laurel Eakin
- Gavin Michael Gleason
- Amber Nichole Hale
- Amanda Hathcock
- Janelle Leslie Kennedy
- Life Essentials LLC
- Lopp Family Dental PC
- Clarence Lee Lopp II
- Mackenzie K. Lopp
- Lizabeth Lee Marks-Shepard
All providers in Brookston, IN · Home Modifications Contractor in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.