Individual
KRISTINE ELIZABETH DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC, FNP-C
Contact information
Practice address
2222 RIETH BLVD, STE 100, GOSHEN, IN 46526-5869
(574) 875-1200
(574) 875-0362
Mailing address
3245 HEALTH DR, GRANGER, IN 46530-1380
(574) 647-1840
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71005614A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201313630
—
IN
Enumeration date
07/08/2015
Last updated
04/28/2023
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