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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427013952 NPPES
Indiana MEDICAID 1002555200
Indiana Other 000000752605
Indiana Other P01011306

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