Provider Demographics
NPI:1851098313
Name:OSWALT, KIRSTEN ELAINE (NP-C)
Entity Type:Individual
Prefix:MS
First Name:KIRSTEN
Middle Name:ELAINE
Last Name:OSWALT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:IN
Mailing Address - Zip Code:46167-9548
Mailing Address - Country:US
Mailing Address - Phone:317-403-3582
Mailing Address - Fax:
Practice Address - Street 1:9070 E 56TH ST STE 400
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-7074
Practice Address - Country:US
Practice Address - Phone:317-268-3600
Practice Address - Fax:317-268-3399
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28244061A163W00000X
IN71014353A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse