Individual
KRYSTAL LEE BAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
8895 BROADWAY, MERRILLVILLE, IN 46410-7037
(219) 738-2081
(219) 736-4658
Mailing address
8895 BROADWAY, MERRILLVILLE, IN 46410-7037
(219) 738-2081
(219) 736-4658
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28180105A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006179A
IN
363LF0000X
Family Nurse Practitioner
F0915531
IN
Other
Enumeration date
03/08/2016
Last updated
05/04/2020
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