Individual
MRS. KANDIE ANN FOREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2349 LAKE AVE, SUITE 201, PLYMOUTH, IN 46563-7835
(574) 941-2977
(574) 941-2978
Mailing address
2349 LAKE AVE STE 99, PLYMOUTH, IN 46563-7837
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71001824A
IN
363LF0000X
Family Nurse Practitioner
Primary
71001824
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200502780
—
IN
Enumeration date
04/02/2007
Last updated
11/27/2023
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