Individual
MARY P KUSTRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 W 61ST AVE, HOBART, IN 46342-6490
(219) 947-6448
(219) 947-6839
Mailing address
320 W 61ST AVE, HOBART, IN 46342-6490
(219) 947-6448
(219) 947-6839
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28150133A
IN
363LF0000X
Family Nurse Practitioner
Primary
71008629A
IN
Other
Enumeration date
08/16/2018
Last updated
12/18/2018
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