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1417339896
TABITHA J BANE
FORT WAYNE, IN
NPI
1417339896
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IN 71005510A)
Enumeration Date
2015-06-23
Last Update Date
2023-04-25
Business Address
TABITHA J BANE
11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845-1673
Phone number: 260-425-6780
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Mailing Address
TABITHA J BANE
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number:
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