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NPI Code Detail

MEDICARE: KRISTIN PERRONE PH.D., H.S.P.P.

MEDICARE: KRISTIN PERRONE PH.D., H.S.P.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist20041593AIN

General Provider Information

NPI Number : 1083759336
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN PERRONE PH.D., H.S.P.P.
Provider Business Mailing Address
First Line : 10629 KENSINGTON LN
Second Line :
City : FORTVILLE
State : IN
Zip : 46040-8900
Country : US
Telephone Number : 317-441-6687
Fax Number :
Provider Business Practice Location Address
First Line : 3301 W PURDUE AVE
Second Line :
City : MUNCIE
State : IN
Zip : 47304-6356
Country : US
Telephone Number : 765-284-0043
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 05/12/2025

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