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1245955095
IVY CUSTER
FORT WAYNE, IN
NPI
1245955095
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IN 71013312A)
Enumeration Date
2022-10-04
Last Update Date
2023-03-23
Business Address
IVY CUSTER APRN
1234 E DUPONT RD STE 3
FORT WAYNE, IN 46825-1545
Phone number: 260-425-5970
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Mailing Address
IVY CUSTER APRN
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number:
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