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General NPI Number Information
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NPI Number | 1487589941
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Entity Type | Individual
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Provider Name | KIESHA D CARLISLE LPN
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Gender | Female
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Dates
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Enumeration Date | 06/16/2026
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Last Update Date | 06/16/2026
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Provider Practice Location Address
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Address Line | 6008 MAGDALENE DR APT B
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City | INDIANAPOLIS
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State | IN
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Zip | 46224-8055
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Country | US
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Telephone | 317-384-9962
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Fax |
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Provider Business Mailing Address
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Address Line | 6008 MAGDALENE DR APT B
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City | INDIANAPOLIS
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State | IN
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Zip | 46224-8055
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Country | US
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Telephone | 317-384-9962
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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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 27082186A
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License Number State | IN
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