Individual
SHAWN KITZMILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
Mailing address
5052 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 408-2203
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
02/19/2022
Last updated
05/02/2024
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