ELISA BERGQUIST

LA PORTE, IN
NPI1922476878
Former NameELISA LAWSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IN  71005757A)
Enumeration Date2015-09-09
Last Update Date2020-09-18
Business Address
ELISA BERGQUIST NP
500 LEGACY PLZ W
LA PORTE, IN 46350-5254
Phone number: 219-326-0943
Mailing Address
ELISA BERGQUIST NP
401 NEWPORTE BLVD
LA PORTE, IN 46350-2479
Phone number: 219-575-6244
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