Individual
LISA KAY KRILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6326 CONSTITUTION DR, FORT WAYNE, IN 46804-1518
(260) 515-3275
Mailing address
9496 E 375 N, CHURUBUSCO, IN 46723-9350
(260) 466-2159
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28189312A
IN
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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