Provider Demographics
NPI:1093427734
Name:LYNCH, KRISTEN (FNP-C)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S LAKE PARK AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6791
Mailing Address - Country:US
Mailing Address - Phone:219-942-6166
Mailing Address - Fax:219-942-4106
Practice Address - Street 1:1400 S LAKE PARK AVE STE 400
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6791
Practice Address - Country:US
Practice Address - Phone:219-942-6166
Practice Address - Fax:219-942-4106
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71013357A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner