KENEDI ELLEN ELIZABETH DIVINE

JASPER, IN
NPI1275276560
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IN  01096665A)
Enumeration Date2022-04-15
Last Update Date2025-07-10
Business Address
KENEDI ELLEN ELIZABETH DIVINE MD
751 W 9TH ST
JASPER, IN 47546-2609
Phone number: 812-996-7474
Mailing Address
KENEDI ELLEN ELIZABETH DIVINE MD
751 W 9TH ST
JASPER, IN 47546-2609
Phone number: 812-996-7474