Individual
KRYSTAL MARIE LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12751 PENNSYLVANIA ST STE 120, CARMEL, IN 46032-5517
(317) 621-9400
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003005A
IN
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0022612
—
OH
Enumeration date
05/08/2020
Last updated
01/06/2026
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