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Individual

KERRI A. KISSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 MEMORIAL SQ STE 2200, GREENFIELD, IN 46140-1378
(317) 462-6662
(317) 468-6275
Mailing address
1 MEMORIAL SQ STE 50, GREENFIELD, IN 46140-1357
(317) 468-6270

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD430427
PA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
01083027A
IN
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
MD430427
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02889256
NY
01
039812
MEDICARE GROUP
PA
05
1019360730001
PA
01
CC9269
RR MEDICARE GROUP
PA
01
GU039812
MEDICARE GROUP
PA
01
P00424192
RR MEDICARE PIN
PA
Enumeration date
02/19/2007
Last updated
01/09/2025
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