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NPI Code Detail

MEDICARE: KARI KLISURICH

MEDICARE:   KARI  KLISURICH
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
1163W00000XRegistered Nurse28209136AIN
2363LF0000XFamily Nurse Practitioner71009330BIN

General Provider Information

NPI Number : 1568015592
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARI KLISURICH
Provider Business Mailing Address
First Line : 3145 45TH ST STE M
Second Line :
City : HIGHLAND
State : IN
Zip : 46322-3292
Country : US
Telephone Number : 219-922-9150
Fax Number : 219-922-9180
Provider Business Practice Location Address
First Line : 3145 45TH ST STE M
Second Line :
City : HIGHLAND
State : IN
Zip : 46322-3292
Country : US
Telephone Number : 219-922-9150
Fax Number : 219-922-9180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2019
Last Update Date : 09/11/2019

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Directions to “ KARI KLISURICH ” Practice Location

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