Individual
CARLY DEARTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5521 W LINCOLN HWY, CROWN POINT, IN 46307-1097
(219) 769-1362
Mailing address
7028 E 110TH LN, CROWN POINT, IN 46307-9433
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209022620
IL
Other
Enumeration date
05/25/2021
Last updated
02/20/2023
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