Individual
MS. KANISHA LOUIS JEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8700 GEORGIA AVE, SILVER SPRING, MD 20910-3618
(301) 585-6049
(301) 588-7365
Mailing address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 825-9660
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
363L00000X
Nurse Practitioner
RN2330675
MA
363LF0000X
Family Nurse Practitioner
Primary
NP500022581
MD
Other
Enumeration date
07/11/2016
Last updated
06/02/2025
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