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Individual

KENDRA A MISBACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
1601 MEDICAL ARTS BLVD, STE 102, ANDERSON, IN 46011-3434
(765) 298-4545
(765) 298-4945
Mailing address
6983 HILLSDALE CT, INDIANAPOLIS, IN 46250-2054
(317) 308-2800
(317) 576-6311

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71004574A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201183850
IN
01
P01403068
RAILROAD MEDICARE
IN
Enumeration date
07/29/2013
Last updated
04/03/2015
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