Physician Compare National (NPI:1710499298)

HEALTHCARE PROVIDER: CHRISTY MARIE KERSEY FNP-C

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1710499298
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6507126893
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180206001146
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KERSEY
	Individual professional last name
Provider First Name	CHRISTY
	Individual professional first name
Provider Middle Name	MARIE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	INDIANA MEDICAL COLLEGE, SCHOOL OF MEDICINE OF PURDUE UNIVERSITY
	Individual professional's medical school
Graduation Year	2017
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	INDIANA PHLEBOLOGY PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8426156050
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	371 E 84TH DR
	Group Practice or individual's line 1 address
Line 2 Street Address	371 VEIN CLINIC AMERICA
	Group Practice or individual's line 2 address
City	MERRILLVILLE
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	464106484
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2197367165
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y