Individual provider · Type 1 NPI

Shan Li

Gerontology Nurse Practitioner · Crown Point, IN

NPI number 1194569434 Active

Practice location

2100 N Main St # 304
Crown Point, IN 46307-1877

Fax (574) 546-1999

Mailing address

5508 Agape Ln
Valparaiso, IN 46383-1206

Other practice locations

  • 5508 Agape Ln, Valparaiso, IN 46383-1206 · (219) 510-3316

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000X28248448A (IN)
Gerontology Nurse Practitioner Primary 363LG0600X71015549A (IN)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1194569434

Shan Li's National Provider Identifier is 1194569434, issued on Jun 21, 2024. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Crown Point, IN. The record was last updated on Jul 31, 2024.