| NPI | 1700259173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA ROTH Nurse Practitioner 574-891-4920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71002933A) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71002933A) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71002933A) | |
| Enumeration Date | 2015-11-07 |
| Last Update Date | 2019-09-09 |