Individual
KANISHA JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2201 E 46TH ST STE 119, INDIANAPOLIS, IN 46205-1449
(317) 289-9077
Mailing address
2201 E 46TH ST STE 119, INDIANAPOLIS, IN 46205-1449
(317) 289-9077
(317) 289-9077
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
300104002
IN
253Z00000X
In Home Supportive Care Agency
Primary
300104002
IN
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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