MEDICARE: KRISTINE NUNN MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	35001917A	IN

General Provider Information

NPI Number	:	1548666720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE NUNN MFT

Provider Business Mailing Address
First Line	:	3645 E MAIN ST # 234
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-5934
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 S 18TH ST
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-5656
Country	:	US
Telephone Number	:	765-205-3137
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2014
Last Update Date	:	01/19/2026

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