Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary P Kustron

Individual provider Registered Nurse · NPI 1720568017

Mary P Kustron is a Nurse Practitioner in Hobart, Indiana. Qualified in 2016, 10 years ago. Practices with Midwest Express Care 4 LLC, a 63-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
10
Licensed in
IN
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

320 W 61st Ave
Hobart, IN 46342-6490
Phone: (219) 947-6448
Fax: (219) 947-6839
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 71008629A (IN)
Registered Nurse Taxonomy 163W00000X · Licence 28150133A (IN)

Record details

NPI number1720568017
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 16, 2018
Last updated in NPPESDecember 18, 2018
Mailing address320 W 61st Ave, Hobart, IN 46342-6490

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Midwest Express Care 4 Llc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Hobart