Provider Demographics
NPI:1437326881
Name:STARCEVICH, KRISTINE LYNN (CSN, ANP)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:LYNN
Last Name:STARCEVICH
Suffix:
Gender:F
Credentials:CSN, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 E 86TH AVE STE Z
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6236
Mailing Address - Country:US
Mailing Address - Phone:219-769-0777
Mailing Address - Fax:219-755-0608
Practice Address - Street 1:521 E 86TH AVE
Practice Address - Street 2:SUITE Z
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6173
Practice Address - Country:US
Practice Address - Phone:219-769-0777
Practice Address - Fax:219-755-0608
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28121781A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health