is a Nurse Practitioner in South Bend, Indiana. practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for is 1083665673. The last update date is .
's current location address is 926 Erskine Plz, South Bend, Indiana. You can contact this provider via phone number 8006355516 and fax number 5746476514. The mailing address for is 926 Erskine Plz, South Bend, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 926 Erskine Plz, South Bend, Indiana |
| Phone Number | 8006355516 |
| Fax Number | 5746476514 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1083665673 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 926 Erskine Plz |
|---|---|
| City | South Bend |
| State | Indiana (IN) |
| Post Code | 4661432440 |
| Phone Number | 8006355516 |
| Fax Number | 5746476514 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | 71000651A |
|
Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200130710H | IN | -- | |
| 200130710I | IN | -- | |
| 200130710J | IN | -- | |
| 200130710K | IN | -- |
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