Provider Demographics
NPI:1760599500
Name:KANIA, DEANNA S (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:S
Last Name:KANIA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13970 HAWKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:FORTVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46040-9439
Mailing Address - Country:US
Mailing Address - Phone:317-988-3060
Mailing Address - Fax:317-613-2316
Practice Address - Street 1:1481 W 10TH ST # 119
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2803
Practice Address - Country:US
Practice Address - Phone:317-988-3060
Practice Address - Fax:317-613-2316
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN260184481835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy