Provider Demographics
NPI:1427893908
Name:KINCHELOW, YOLANDA RENEE
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:RENEE
Last Name:KINCHELOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4311 LINTON LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-3162
Mailing Address - Country:US
Mailing Address - Phone:317-406-1209
Mailing Address - Fax:317-992-2488
Practice Address - Street 1:4311 LINTON LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-3162
Practice Address - Country:US
Practice Address - Phone:317-406-1209
Practice Address - Fax:317-992-2488
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2401734413747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider