Provider Demographics
NPI:1043655210
Name:KINDER, ALLISON ELISE (ANP-BC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ELISE
Last Name:KINDER
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:MUELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:
Practice Address - Street 1:8955 W 400 N
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-9330
Practice Address - Country:US
Practice Address - Phone:219-861-5544
Practice Address - Fax:219-861-5800
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71009920A363L00000X
IL209010385363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209010385OtherLICENSED ADVANCED PRACTICE NURSE