Healthcare Provider Details

I. General information

NPI: 1619639630
Provider Name (Legal Business Name): KRISTA RENEE LINSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 45TH ST STE 3
HIGHLAND IN
46322-3277
US

IV. Provider business mailing address

7428 SUNSET RIDGE PKWY
INDIANAPOLIS IN
46259-7648
US

V. Phone/Fax

Practice location:
  • Phone: 888-998-7337
  • Fax:
Mailing address:
  • Phone: 317-979-4779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71011693A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71011693A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: