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General NPI Number Information
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NPI Number | 1851243836
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Entity Type | Individual
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Provider Name | KYLIE M CROCKETT ARNP
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Gender | Female
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 9465 COUNSELORS ROW
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-6423
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Country | US
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Telephone | 202-681-9661
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Fax |
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Provider Business Mailing Address
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Address Line | 1780 W COUNTY ROAD 850 N
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City | LIZTON
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State | IN
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Zip | 46149-9341
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Country | US
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Telephone | 618-779-5073
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71017744A
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License Number State | IN
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