| NPI | 1376148593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MACKEN-MARBLE CEO 574-231-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2020-12-10 |