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Individual

KRISTEN L FOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3309 S 750 W, RUSSIAVILLE, IN 46979-9146
(765) 765-8832
Mailing address
3309 S 750 W, RUSSIAVILLE, IN 46979-9146

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002315A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300009006
IN
Enumeration date
09/26/2017
Last updated
05/12/2021
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