Individual
KRISTIN OSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8865 W 400 N STE 120, MICHIGAN CITY, IN 46360-9011
(219) 878-5031
(219) 879-5498
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001513A
IN
363A00000X
Physician Assistant
TC047
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300007766
—
IN
05
—
7100002730
—
KY
Enumeration date
10/05/2006
Last updated
07/24/2024
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