Kanis, Jessica M
Kanis, Jessica M is an individual health care provider with primary practice located at 705 Riley Drive , Indianapolis IN 46202-5109. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Clinical Informatics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is her primary health care specialty. Kanis, Jessica M can be contacted via phone (317) 944-3936.Contact Information
Primary practice address
705 Riley Drive
Indianapolis IN 46202-5109
Phone: (317) 944-3936
Fax: (317) 948-5844
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35.094922 | Ohio |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 01072885A | Indiana |
| Allopathic & Osteopathic Physicians / Clinical Informatics | 2083C0008X | 01072885A | Indiana |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 01072885A | Indiana |
Profile Details
| NPI number | 1558442715 |
|---|---|
| LBN Legal business name | Kanis, Jessica M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 17th, 2006 |
| Last updated | Aug 30th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558442715 | NPPES |
| Indiana | MEDICAID | 201057370 | |
| Indiana | Other | 000000835642 |
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