MINDY KAY KRSAK (NPI# 1912462664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912462664 |
| Entity Type | Individual |
| Full Name | MINDY KAY KRSAK |
| Credential | CPNP |
| Practice Address |
3229 Broadway Ste 205 Gary IN 46409-1038 |
| Practice Telephone | 2198063000 |
| Mailing Telephone | 2198063000 |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2019-02-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
71008698A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3229 BROADWAY STE 205 |
| City | GARY |
| State | IN |
| Zip Code | 46409-1038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578115234 | Channae Watkins | Nurse Practitioner | 3229 Broadway Ste 205, Gary, IN 46409-1038 | 2019-07-12 |
| 1013479260 | Amanda Joy Dech | Nurse Practitioner | 3229 Broadway Ste 205, Gary, IN 46409-1038 | 2019-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316027998 | Nhi Home Base Service Corp. | Clinic/Center | 4795 Broadway, Gary, IN 46409 | 2006-10-17 |
| 1164891404 | Megan Burgess | Counselor | 4795 Broadway, Gary, IN 46409 | 2015-09-16 |
| 1366677213 | Merideth Krashonda Owens | Counselor | 4795 Broadway, Gary, IN 46409 | 2009-05-21 |
| 1548530439 | Sibis Counseling Center LLC | Counselor | 3195 Broadway Lowr Level, Gary, IN 46409-1006 | 2012-01-09 |
| 1750303343 | Adolphus A Anekwe | Specialist | 3195 Broadway, Gary, IN 46409-1006 | 2006-07-24 |
| 1215219084 | Broadway Dental Services | Dentist | 3195 Broadway, Gary, IN 46409-1006 | 2011-09-16 |
| 1528392156 | Tonya A. Harvey | Nurse Practitioner | 3195 Broadway, Gary, IN 46409-1006 | 2009-09-29 |
| 1629196761 | Broadway Medical Corporation, PC | Specialist | 3195 Broadway, Gary, IN 46409-1006 | 2007-03-27 |
| 1023166758 | Frank Edward Pate | Dentist | 3195 Broadway, Gary, IN 46409-1006 | 2007-01-08 |
| 1528173853 | Edwin Kenneth Mcdonald IIi | Dentist | 3195 Broadway, Gary, IN 46409-1006 | 2006-08-19 |
| Find all providers in zip 46409 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822844 | Kelsey M Knight | Nurse Practitioner | 705 Riley Hospital Dr Ste 1601, Indianapolis, IN 46202-5109 | 2020-08-21 |
| 1699306241 | Amber Barney | Nurse Practitioner | 3611 S Lafountain St, Kokomo, IN 46902 | 2020-02-03 |
| 1700420031 | Randi D Bragg | Nurse Practitioner | Marion Pediatrics, 1411w Bella Drive, Marion, IN 46953-5250 | 2019-10-30 |
| 1659923761 | Elizabeth Marie Bowen | Nurse Practitioner | 13914 Southeastern Pkwy Ste 300, Fishers, IN 46037-7126 | 2019-07-10 |
| 1497221154 | Christina Ownbey | Nurse Practitioner | 517 Ball Dr Unit 302, Hanover, IN 47243-9656 | 2018-10-22 |
| 1578056842 | Jenna Elizabeth Bednarski | Nurse Practitioner | 3741 Rome Dr Ste B, Lafayette, IN 47905-4490 | 2018-06-12 |
| 1427594696 | Alecia A Woody | Nurse Practitioner | 3400 Lafayette Rd, Suite 200, Shalom Health Care Center Inc, Indianapolis, IN 46222-1146 | 2017-01-12 |
| 1043688211 | Mary Hendrix | Nurse Practitioner | 3118 S Lafountain St # At, Kokomo, IN 46902-3710 | 2015-09-04 |
| 1487022810 | Hannah Renfrow | Nurse Practitioner | 1411 W Bella Drive, Marion, IN 46953 | 2015-09-02 |
| 1962803684 | Brett Parsons Pearlman | Nurse Practitioner | 218 W 161st St # A, Westfield, IN 46074-9623 | 2014-09-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.