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General NPI Number Information
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NPI Number | 1588876148
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Entity Type | Individual
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Provider Name | LYNN MARIE MISKOVICH APN
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 04/27/2015
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Provider Practice Location Address
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Address Line | 5514 S HOHMAN AVE
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City | HAMMOND
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State | IN
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Zip | 46320-1933
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Country | US
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Telephone | 219-933-2018
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Fax |
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Provider Business Mailing Address
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Address Line | 8722 FOREST GLEN CT
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City | SAINT JOHN
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State | IN
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Zip | 46373-8795
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Country | US
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Telephone | 219-741-2568
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 71001061A
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License Number State | IN
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