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General NPI Number Information
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NPI Number | 1366270266
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Entity Type | Individual
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Provider Name | KISHA EDWARDS NP
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Gender | Female
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Dates
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Enumeration Date | 07/23/2024
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 5510 S EAST ST STE H
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-1939
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Country | US
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Telephone | 317-924-8425
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Fax | 317-924-8424
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Provider Business Mailing Address
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Address Line | 120 W 22ND ST
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City | OAK BROOK
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State | IL
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Zip | 60523-1557
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Country | US
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Telephone | 630-573-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71015530A
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License Number State | IN
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