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NPI Code Detail

MEDICARE: KYLIE M CROCKETT ARNP

MEDICARE: KYLIE M CROCKETT ARNP
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
1363LF0000XFamily Nurse Practitioner71017744AIN

General Provider Information

NPI Number : 1851243836
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLIE M CROCKETT ARNP
Provider Business Mailing Address
First Line : 1780 W COUNTY ROAD 850 N
Second Line :
City : LIZTON
State : IN
Zip : 46149-9341
Country : US
Telephone Number : 618-779-5073
Fax Number :
Provider Business Practice Location Address
First Line : 9465 COUNSELORS ROW
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46240-6423
Country : US
Telephone Number : 202-681-9661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/12/2026

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Directions to “ KYLIE M CROCKETT ARNP” Practice Location

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