Qualls, Kristene

Qualls, Kristene is an individual health care provider with primary practice located at 524 E Mckinley Ave , Mishawaka IN 46545-6285. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Qualls, Kristene can be contacted via phone (574) 256-2556.

Contact Information

Primary practice address
524 E Mckinley Ave Mishawaka IN 46545-6285
Phone: (574) 256-2556
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71005344A Indiana

Profile Details

NPI number 1750770053
LBN Legal business name Qualls, Kristene
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2015
Last updated Nov 21st, 2016 - about 9 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 1750770053 NPPES
Indiana MEDICAID 201282570

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