Provider Demographics
NPI:1720788102
Name:FIDLER, KARLI ELIZABETH (NREMT)
Entity Type:Individual
Prefix:
First Name:KARLI
Middle Name:ELIZABETH
Last Name:FIDLER
Suffix:
Gender:F
Credentials:NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1764 N 175 E
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-7127
Mailing Address - Country:US
Mailing Address - Phone:765-307-0082
Mailing Address - Fax:
Practice Address - Street 1:610 PURDUE MALL
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47907-2040
Practice Address - Country:US
Practice Address - Phone:765-307-0082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
314412OtherNATA