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Individual
CYNTHIA KAY KIESEL
Active
Individual
CYNTHIA KAY KIESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002188A
IN
363LF0000X
Family Nurse Practitioner
71002188A
IN
363LP2300X
Primary Care Nurse Practitioner
71002188A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000545658
ANTHEM PIN
IN
01
—
200859330E
MEDICAID GROUP
IN
05
—
200885350
—
IN
01
—
250470
MEDICARE GROUP
IN
Enumeration date
02/19/2007
Last updated
11/26/2019
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