LEANNA CAROL FANDL

PORTAGE, IN
NPI1700162823
Professional NameLEANNA DIPERT FANDL
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IN  28105935A)
Enumeration Date2011-11-03
Last Update Date2015-01-30
Business Address
-- LEANNA CAROL FANDL NP
6615 S BOUNDARY RD
PORTAGE, IN 46368-1373
Phone number: 219-787-8662
Mailing Address
-- LEANNA CAROL FANDL NP
6615 S BOUNDARY RD
PORTAGE, IN 46368-1373
Phone number: 219-787-8662
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