Unknown Individual – Nurse Practitioner, NPI 1114917481
Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
707 CEDAR ST STE 200
SOUTH BEND, IN 466172057
Phone: (574) 335-8707
Type: Mailing
211 N Eddy St
South Bend, IN 466172808
Phone: (574) 237-9231
Fax: (574) 237-9208
Type: Location
Douglas Road, Mishawaka, Saint Joseph County, Indiana, 46545, United States
MISHAWAKA, IN 465451467
Phone: (574) 335-7650
Fax: (574) 335-0736
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46617)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | IN | |
| Nurse Practitioner | IN | |
| Internal Medicine, Family Practice, Emergency Medicine | IN | |
| - | IN | |
| - | IN | |
| N E U R O L O G Y | IL | |
| - | IN | |
| U R O L O G Y | FL | |
| Physician Assistant | MN | |
| Nurse Practitioner | IN |
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