Individual
KANEISHA BURRUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10853 MISTFLOWER WAY, INDIANAPOLIS, IN 46235-3563
(317) 406-1299
Mailing address
10853 MISTFLOWER WAY, INDIANAPOLIS, IN 46235-3563
(317) 406-1299
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
20014891
IN
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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