Individual
DEBORAH LOUISE KARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 N MAIN ST STE D, CROWN POINT, IN 46307-3281
(219) 663-4877
(219) 663-4877
Mailing address
300 N MAIN ST STE D, CROWN POINT, IN 46307-3281
(219) 663-4877
(219) 663-4877
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
71000240A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200118190
—
IN
01
—
IN2007002
MEDICARE#
IN
Enumeration date
09/15/2006
Last updated
07/28/2022
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