Individual
KRISTINA ANN VANNATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8240 NAAB RD STE 100, INDIANAPOLIS, IN 46260-1985
(317) 338-7450
Mailing address
11541 E WINCHESTER LN, ELLICOTT CITY, MD 21042-2040
(443) 996-4400
(317) 582-8852
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1000240A
IN
Other
Enumeration date
09/08/2018
Last updated
12/09/2020
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