Individual
MISS KILEY ELIZABETH WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 MACARTHUR BLVD STE 6, MUNSTER, IN 46321-2917
(219) 703-2417
(219) 703-6947
Mailing address
605 N COURT ST, CROWN POINT, IN 46307-3143
(219) 384-4360
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.008341
IL
363A00000X
Physician Assistant
Primary
10003336A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300053546
—
IN
Enumeration date
06/23/2021
Last updated
11/23/2022
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