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Contact Information

KRISTIN M WYMER, NP
211 N EDDY ST
SOUTH BEND, IN46617-3096
 Phone: 574-237-9231
 Fax: 574-204-6355
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Registered Nurse First Assistant

163WR0006X
Indicates primary specialty

NPI Profile & details for KRISTIN M WYMER · (Female)

NPI # 1679058762
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 09/25/2018
Last updated 04/29/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 28193580A
  • IN License # 71008462A
  • IN Medicaid 300020098
  • IN Other 169380084 MEDICARE PTAN
  • IN Other 247000032 MEDICARE PTAN
  • IN Other 261970104 MEDICARE PTAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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