=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992314504
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ABBI DANAE KROLL NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2020
-----------------------------------------------------
Last Update Date | 09/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3500 FRANCISCAN WAY
-----------------------------------------------------
City | MICHIGAN CITY
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46360-0021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-852-1524
-----------------------------------------------------
Fax | 219-933-2288
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1104 6TH ST
-----------------------------------------------------
City | LA PORTE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46350-5408
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-369-6008
-----------------------------------------------------
Fax | 219-380-5127
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 71010291A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163WE0003X
-----------------------------------------------------
Taxonomy Name | Emergency Registered Nurse
-----------------------------------------------------
License Number | 28235925A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number | 71010291A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------