Individual
ALISON G KANESHIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528
(574) 753-7541
Mailing address
1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528
(574) 753-7541
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209009028
IL
363L00000X
Nurse Practitioner
Primary
71005293A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001042126
ANTHEM
IN
05
—
201378490
—
IN
01
—
P01756393
RAILROAD MEDICARE
IN
Enumeration date
08/31/2011
Last updated
03/15/2017
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