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Individual

MS. CAMI JO KISTENFEGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPAS, PA-C

Contact information

Practice address
53880 CARMICHAEL DR, SOUTH BEND, IN 46635-1567
(574) 247-9441
(745) 247-9442
Mailing address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.003920
IL
363A00000X
Physician Assistant
Primary
10004288A
IN

Other

Enumeration date
09/27/2010
Last updated
09/03/2024
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