Individual
DR. CARIANNE NICOLE LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
(574) 272-9000
Mailing address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
(773) 547-3065
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016005276
IL
213E00000X
Podiatrist
Primary
SC006327
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/09/2007
Last updated
09/08/2021
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