Kristen R Novak, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71009601A Issued in IN

Practice address

8865 W 400 N Ste 155
Michigan City, IN 46360-9010

Phone

(219) 872-6566

NPI assigned

Nov 14, 2019

Last updated

Dec 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1033754080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8865 W 400 N STE 155",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609010",
            "telephone_number": "219-872-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "KRISTEN",
        "middle_name": "R",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28240318A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009601A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vidas Thomas Noreika, D.D.S.
• Northshore Health Centers, Inc. (NorthShore Michigan City Health Center)
• Northwest Indiana Oncology PC
• Bennett C Nott, LCSW
• Ahmed Nour, DO
• Tracy Len Novak, AGACNP
• Samantha Jo Nuppnau, PHARMD, RPH
• Nwi Foot and Ankle Clinic
• Oak Brook Foot & Ankle Specialists PC (Momentum Foot and Ankle Clinics)
• Khalilah Odom

• Family Nurse Practitioner in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.