Provider Demographics
NPI:1609699628
Name:AMERICAN KIDNEY CLINICS
Entity type:Organization
Organization Name:AMERICAN KIDNEY CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ARANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISELR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:260-436-1248
Mailing Address - Street 1:5010 W JEFFERSON BLVD # 100
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-6804
Mailing Address - Country:US
Mailing Address - Phone:260-436-1248
Mailing Address - Fax:260-436-7968
Practice Address - Street 1:5010 W JEFFERSON BLVD # 100
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-6804
Practice Address - Country:US
Practice Address - Phone:260-436-1248
Practice Address - Fax:260-436-7968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty