Organization · Type 2 NPI
Healthy Body LLC
Gerontology Nurse Practitioner · Fort Wayne, IN
NPI number
1508389990
Active
Practice location
2515 Ladue Ln
Fort Wayne, IN 46804-2796
Mailing address
7619 W Jefferson Blvd
Fort Wayne, IN 46804-4133
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 71006194A (IN) |
Gerontology Nurse Practitioner: Definition to come...
Other gerontology nurse practitioner providers in Fort Wayne
About NPI 1508389990
Healthy Body LLC's National Provider Identifier is 1508389990, issued on Jul 18, 2017. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Fort Wayne, IN. The record was last updated on Jul 18, 2017.