Individual
LYNETTE CHRISTINE POLSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 751-6212
(765) 751-2759
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
(317) 948-9174
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
71012024A
IN
363LN0005X
Critical Care Neonatal Nurse Practitioner
28170323A
IN
Other
Enumeration date
10/13/2021
Last updated
08/25/2022
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