Provider Demographics
NPI:1932697745
Name:DISHMAN-KESSLER, CASSANDRA NICOLE (DO)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:NICOLE
Last Name:DISHMAN-KESSLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:DISHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1302 S ROGERS ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-4752
Practice Address - Country:US
Practice Address - Phone:812-353-3700
Practice Address - Fax:812-353-5859
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102206677207Q00000X
390200000X
IN02006724A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program