Individual
KRISTEN M BAGOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1355 MARINERS DR, WARSAW, IN 46582-7145
(574) 372-0040
Mailing address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71010271A
IN
363LF0000X
Family Nurse Practitioner
Primary
71010271A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0026075
—
OH
Enumeration date
08/13/2020
Last updated
06/29/2026
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