Wymer, Kristin Marie
Wymer, Kristin Marie is an individual health care provider with primary practice located at 211 N Eddy St , South Bend IN 46617-3096. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse First Assistant, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Wymer, Kristin Marie can be contacted via phone (574) 237-9231.Contact Information
Primary practice address
211 N Eddy St
South Bend IN 46617-3096
Phone: (574) 237-9231
Fax: (574) 204-6355
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse First Assistant | 163WR0006X | 28193580A | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 71008462A | Indiana |
Profile Details
| NPI number | 1679058762 |
|---|---|
| LBN Legal business name | Wymer, Kristin Marie |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 25th, 2018 |
| Last updated | Apr 29th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679058762 | NPPES |
| Indiana | Other | 169380084 | MEDICARE PTAN |
| Indiana | Other | 247000032 | MEDICARE PTAN |
| Indiana | Other | 261970104 | MEDICARE PTAN |
| Indiana | MEDICAID | 300020098 | MEDICARE PTAN |
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