person
Krystal Kay Lavine
Family Nurse Practitioner in Bourbon, Indiana
NPI 1821586207

Krystal Kay Lavine is a Family Nurse Practitioner based in South Bend, IN and is specialized in Family. Krystal Kay Lavine practices in Bourbon, IN. The NPI Number for Krystal Kay Lavine is 1821586207 and holds a License No. 71008330A (Indiana).

The current practice location address for Krystal Kay Lavine is 114 N Washington St, Bourbon, IN and can be reached out via phone at 574-335-7850 and via fax at 574-335-0755. You can also correspond with Krystal Kay Lavine through the mailing address at 707 CEDAR ST STE 405, SOUTH BEND, IN - 46617-2059 (mailing address contact number: ).

Location: 114 N Washington St, Bourbon, IN, 46617-2059
person
Provider Profile Details
NPI Number
1821586207
Provider Name
Krystal Kay Lavine
Credential
Provider Entity Type
Individual
Gender
Female
Address
114 N Washington St, Bourbon, IN, 46617-2059
Phone Number
574-335-7850
Fax Number
574-335-0755
Provider Enumeration Date
05/01/2018
Last Update Date
03/10/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
1102236362 01 IN ANTHEM
300020124 05 IN
institution
Provider Business Practice Location Address Details
Address
114 N Washington St
City
State
Zip
46504-1623
Phone Number
574-335-7850
Fax Number
574-335-0755
person
Provider Business Mailing Address Details
Address
114 N Washington St
City
State
Zip
46504-1623
Phone Number
574-335-7850
Fax Number
574-335-0755
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
71008330A (Indiana)
Definition
Definition to come...
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