GUINEVERE M NILLES

FORT WAYNE, IN
NPI1265819064
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IN  10001910A)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2015-04-30
Last Update Date2020-07-23
Business Address
GUINEVERE M NILLES PA
7910 W JEFFERSON BLVD STE 108
FORT WAYNE, IN 46804-4159
Phone number: 260-484-8830
Mailing Address
GUINEVERE M NILLES PA
6610 MUTUAL DR
FORT WAYNE, IN 46825-4236
Phone number: 260-484-8830