Individual
KRISTAL L MYLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2605 N LEBANON ST, LEBANON, IN 46052-1476
(765) 485-8000
Mailing address
2605 N LEBANON ST, LEBANON, IN 46052-1476
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10001675A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300012250
—
IN
Enumeration date
07/14/2014
Last updated
09/22/2023
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