Individual
DR. CHRISTY LYNN ANNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5215 HOLY CROSS PKWY, EMERGENCY DEPARTMENT, MISHAWAKA, IN 46545-1469
(574) 335-5000
Mailing address
5215 HOLY CROSS PKWY, EMERGENCY DEPARTMENT, MISHAWAKA, IN 46545-1469
(574) 335-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01069919
IN
207P00000X
Emergency Medicine Physician
036.125342
IL
207P00000X
Emergency Medicine Physician
57.012518
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000724321
ANTHEM
IN
05
—
201028090
—
IN
01
—
P00967673
RR MEDICARE
IN
Enumeration date
04/17/2007
Last updated
12/16/2011
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