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Individual

HEATHER A CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
2405 W LEXINGTON AVE, ELKHART, IN 46514-1417
(574) 524-7575
(574) 524-7575
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71015192A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300093448
IN
Enumeration date
04/22/2024
Last updated
04/08/2026
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