Provider Demographics
NPI:1952173379
Name:KILPATRICK, YHANEKE (RN)
Entity Type:Individual
Prefix:
First Name:YHANEKE
Middle Name:
Last Name:KILPATRICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 W PHILADELPHIA DR
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-9490
Mailing Address - Country:US
Mailing Address - Phone:317-315-7936
Mailing Address - Fax:
Practice Address - Street 1:6715 W PHILADELPHIA DR
Practice Address - Street 2:
Practice Address - City:MCCORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46055-9490
Practice Address - Country:US
Practice Address - Phone:317-315-7936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL28219826A163W00000X
IN28219826A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered Nurse