Individual
KYLA SCHRECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
714 LINCOLNWAY, LA PORTE, IN 46350-3353
(219) 763-8112
(219) 728-1639
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 764-5380
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209019364
IL
363LF0000X
Family Nurse Practitioner
Primary
71009800A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300036645
—
IN
Enumeration date
06/14/2019
Last updated
04/15/2020
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