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KIMBERLY LICHTENFELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
11161 RANDOLPH ST, CROWN POINT, IN 46307-8564
(219) 664-9424
(219) 662-7465
Mailing address
PO BOX 781076, DETROIT, MI 48278-2892
(317) 528-4800

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71004567A
IN

Other

Enumeration date
08/21/2013
Last updated
10/11/2023
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