Provider Demographics
NPI:1558845644
Name:LEVER, KISHA (HCC, CNA)
Entity Type:Individual
Prefix:MS
First Name:KISHA
Middle Name:
Last Name:LEVER
Suffix:
Gender:F
Credentials:HCC, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4411 E CHANDLER BLVD APT 2032
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-7670
Mailing Address - Country:US
Mailing Address - Phone:414-379-7145
Mailing Address - Fax:
Practice Address - Street 1:4411 E CHANDLER BLVD APT 2032
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-7670
Practice Address - Country:US
Practice Address - Phone:414-379-7145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health