Kenny, Agnes
Kenny, Agnes is an individual health care provider with primary practice located at 1694 W Logansport Rd , Peru IN 46970-3149. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Kenny, Agnes can be contacted via phone (765) 472-2812.Contact Information
Primary practice address
1694 W Logansport Rd
Peru IN 46970-3149
Phone: (765) 472-2812
Fax: (765) 472-2970
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 01031072A | Indiana |
Profile Details
| NPI number | 1427013952 |
|---|---|
| LBN Legal business name | Kenny, Agnes |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 18th, 2006 |
| Last updated | Aug 15th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427013952 | NPPES |
| Indiana | MEDICAID | 1002555200 | |
| Indiana | Other | 000000752605 | |
| Indiana | Other | P01011306 |
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