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1871200360
NATHANIAL DAVID SCHAEFER
FORT WAYNE, IN
NPI
1871200360
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: IN 2022060453)
Enumeration Date
2022-11-03
Last Update Date
2022-11-03
Business Address
Mr. NATHANIAL DAVID SCHAEFER
6326 CONSTITUTION DR
FORT WAYNE, IN 46804-1518
Phone number: 260-271-9821
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Mailing Address
Mr. NATHANIAL DAVID SCHAEFER
15023 CYPRESS POINTE DR
FORT WAYNE, IN 46818-9256
Phone number: 260-271-9821
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