Individual
DR. KIMBERLY JEAN VANRYZIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1701 N SENATE BLVD # B401, INDIANAPOLIS, IN 46202
(317) 962-5975
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
(317) 963-2849
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11018313A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300015016
—
IN
Enumeration date
06/17/2015
Last updated
07/10/2018
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