Provider Demographics
NPI:1144635475
Name:RAPP, KRISTIN BAILEY (NP)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:BAILEY
Last Name:RAPP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15429 ACKERLEY DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46040-1476
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:69 E GARNER RD STE 300
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-7000
Practice Address - Country:US
Practice Address - Phone:317-852-3616
Practice Address - Fax:317-852-6969
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004969A363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201237090Medicaid
IN266180475Medicare PIN