| Heather S Gengnagel, NP | |
|
12750 Saint Francis Dr Ste 320, Crown Point, IN 46307-0264 | |
| (219) 662-0077 | |
| (219) 662-9496 |
| Full Name | Heather S Gengnagel |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 12750 Saint Francis Dr Ste 320, Crown Point, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467222331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 28222842A (Indiana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 71014861A (Indiana) | Primary |
| Entity Name | The South Bend Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073680419 PECOS PAC ID: 3779577937 Enrollment ID: O20040412000439 |
| Mailing Address | Practice Location Address |
|---|---|
| Heather S Gengnagel, NP Po Box 781076, Detroit, MI 48278-1076 Ph: (317) 528-4800 | Heather S Gengnagel, NP 12750 Saint Francis Dr Ste 320, Crown Point, IN 46307-0264 Ph: (219) 662-0077 |
Nichole Elaine Roberts, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9470 Broadway, Crown Point, IN 46307 Phone: 219-661-3260 Fax: 219-662-3770 | |
James Brown, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2100 N Main St Ste 304, Crown Point, IN 46307 Phone: 574-546-1900 Fax: 574-546-1999 | |
Mrs. Lydia C Buyco, ADULT NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9330 South Broadway Blvd, Crown Point, IN 46307 Phone: 219-662-5072 | |
Faith A Ornelas, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2050 N Main St Ste C, Crown Point, IN 46307 Phone: 219-662-3300 Fax: 219-662-3301 | |
Anita D Arthur, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2100 N Main St Ste 304, Crown Point, IN 46307 Phone: 574-546-1900 Fax: 574-546-1999 | |
Mrs. Josefina Estrada Offredo, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9330 South Broadway Blvd, Crown Point, IN 46307 Phone: 219-662-5072 | |
Jennifer Lee Virgl, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 12750 St Francis Dr, Crown Point, IN 46307 Phone: 219-757-6121 Fax: 219-681-6897 |