Kresovsky, Gwendolyn Sue

Kresovsky, Gwendolyn Sue is an individual health care provider with primary practice located at 2118 25Th St Ste D , Columbus IN 47201-3240. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Kresovsky, Gwendolyn Sue can be contacted via phone (812) 372-8281.

Contact Information

Primary practice address
2118 25Th St Ste D Columbus IN 47201-3240
Phone: (812) 372-8281
Fax: (812) 372-4525
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 71002463A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71002463A Indiana

Profile Details

NPI number 1649465410
LBN Legal business name Kresovsky, Gwendolyn Sue
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2007
Last updated May 8th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649465410 NPPES
Indiana MEDICAID 201154020
Indiana Other 000000986921

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