| NPI | 1366465452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE D IPPEL Owner 765-836-4874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01026974A) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71001338A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71001495A) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-08-22 |