| |
11420 Broadway, Crown Point, IN 46307-7106 | |
(219) 661-8680 | |
(219) 661-8280 |
Full Name | |
---|---|
Type | Facility |
Speciality | Nurse Practitioner |
Location | 11420 Broadway, Crown Point, Indiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316693328 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
232 Edinburgh St, Valparaiso, IN 46385-9306 Ph: (641) 891-7384 | 11420 Broadway, Crown Point, IN 46307-7106 Ph: (219) 661-8680 |