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Individual

KRISTEN R NOVAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
8865 W 400 N STE 155, MICHIGAN CITY, IN 46360-9010
(219) 872-6566
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28240318A
IN
363LF0000X
Family Nurse Practitioner
Primary
71009601A
IN

Other

Enumeration date
11/14/2019
Last updated
12/17/2019
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