Individual
MS. CHERYL L KIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 672-6620
(260) 672-6639
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001059A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000704771
ANTHEM
IN
Enumeration date
12/17/2008
Last updated
10/20/2022
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