Crossroads Healing Arts, LLC
Family Medicine in Elkhart, IN. Organization (NPI-2).
NPI number1295028694
StatusActive
Last updated in NPPESFeb 12, 2015
Details
- NPI
- 1295028694
- Entity type
- Organization (NPI-2)
- Legal business name
- Crossroads Healing Arts, LLC
- Organization subpart
- No
- Enumeration date
- May 18, 2011
- Last updated
- Feb 12, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 1067015A | IN | Yes |
| 2083P0500X | Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine | 02002929A | IN | |
| 363LW0102X | Nurse Practitioner, Women's Health | 71001272 | IN |
Practice location
1004 Parkway AveSuite C
Elkhart, IN 46516-9326
Phone 574-294-1883 · Fax 574-295-1749
Mailing address
1004 Parkway AveSuite C
Elkhart, IN 46516-9326
Phone 574-294-1883 · Fax 574-295-1749
Authorized official
Kelly J Boyer
Nurse Practitioner/Owner
5742941883
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