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Nurse Practitioner

NPI: 1710632625IndividualAccepts Medicare

Specialties, Licenses & Credentials

Nurse PractitionerPrimary

Nurse Practitioner

Code: 363L00000X

71012324A(IN)

CMS Specialties

Education

OTHER

Class of 2021

Contact & Hours

Address
11104 PARKVIEW CIRCLE DR STE 10
FORT WAYNE, IN 46845

Quick Facts

NPI
1710632625
Entity Type
Individual
Gender
Female
Medicare
Accepted
Specialties
1
Locations
1
Years in Practice
5

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