PHYLLIS ELAINE BRAGG

FORT WAYNE, IN
NPI1861724833
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IN  71003158B)
Enumeration Date2010-02-02
Last Update Date2010-02-02
Business Address
-- PHYLLIS ELAINE BRAGG NP
5546 THORNBRIAR LN
FORT WAYNE, IN 46835-3890
Phone number: 260-750-2074
Mailing Address
-- PHYLLIS ELAINE BRAGG NP
3103 E STATE BLVD
FORT WAYNE, IN 46805-4738
Phone number: 260-373-9330
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