Individual
KRYSTAL ANTRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
401 NEWPORTE BLVD, LAPORTE, IN 46350
(219) 575-6244
Mailing address
401 NEWPORTE BLVD., LAPORTE, IN 46350
(219) 575-6244
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F08211097
IN
Other
Enumeration date
10/02/2023
Last updated
02/09/2024
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