MEDICARE: KAYLA KISKADEN NPDB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZH0000X	Hematology (Pathology) Physician	33000325	IN

General Provider Information

NPI Number	:	1801741699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA KISKADEN NPDB

Provider Business Mailing Address
First Line	:	2108 MCCORMICK RD APT 234
Second Line	:
City	:	WEST LAFAYETTE
State	:	IN
Zip	:	47906-6663
Country	:	US
Telephone Number	:	765-637-5278
Fax Number	:

Provider Business Practice Location Address
First Line	:	2108 MCCORMICK RD APT 234
Second Line	:
City	:	WEST LAFAYETTE
State	:	IN
Zip	:	47906-6663
Country	:	US
Telephone Number	:	765-637-5278
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2026
Last Update Date	:	02/27/2026

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