Krystal Kay Lavine, | |
114 N Washington St, Bourbon, IN 46504-1623 | |
(574) 335-7850 | |
(574) 335-0755 |
Full Name | Krystal Kay Lavine |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 7 Years |
Location | 114 N Washington St, Bourbon, Indiana |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821586207 | NPI | - | NPPES |
300020124 | Medicaid | IN | |
1102236362 | Other | IN | ANTHEM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 71008330A (Indiana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Elara Caring | Kokomo, IN | Home health agency |
Saint Joseph Regional Medical Center - Plymouth | Plymouth, IN | Hospital |
Community Hospital Of Bremen Inc | Bremen, IN | Hospital |
Saint Joseph Regional Medical Center | Mishawaka, IN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Saint Joseph Regional Medical Center Inc | 8325950843 | 101 |
Entity Name | Saint Joseph Regional Medical Center- Plymouth Campus Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538585187 PECOS PAC ID: 9537071337 Enrollment ID: O20031223000588 |
Entity Name | Saint Joseph Regional Medical Center-south Bend Campus Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841245594 PECOS PAC ID: 3476451790 Enrollment ID: O20031223000724 |
Entity Name | Saint Joseph Regional Medical Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225082878 PECOS PAC ID: 8325950843 Enrollment ID: O20040708000757 |
Mailing Address | Practice Location Address |
---|---|
Krystal Kay Lavine, 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 Ph: () - | Krystal Kay Lavine, 114 N Washington St, Bourbon, IN 46504-1623 Ph: (574) 335-7850 |
Mrs. Jennifer Robyn Friberg, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 114 N Washington St, Bourbon, IN 46504 Phone: 574-335-7850 Fax: 574-335-0755 | |
Mrs. Barbara Jane Kunnen, MS, RN, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 114 N Washington St, Bourbon, IN 46504 Phone: 574-335-7850 Fax: 574-335-0755 |