IndividualActive
Cristina Hermosillo, PA-C
NPI 1104607738 · Medical Physician Assistant · Kokomo, IN
Provider details
- NPI number
- 1104607738
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- License
- 10004249A (IN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3118 S Lafountain St
Kokomo, IN 46902-3710
Phone: (765) 864-4160
Fax: (765) 400-4467
Approximate (ZIP-level) locationGet directions
Mailing address
8003 Castleway Dr
Indianapolis, IN 46250-1946
Registry dates
- Enumerated
- 2023-10-10
- Last updated
- 2024-01-25
- Certified
- 2024-01-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.