# MICHIANA CONCIERGE FAMILY MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346958998
- **Authorized official:** GRACIELA JIMENEZ-MARTINEZ NURSE PRACTITIONER (OWNER)
- **Authorized official phone:** (574) 546-0654

## Contact information

- **Practice address:** 1217 W PLYMOUTH ST, BREMEN, IN 46506-1930
- **Practice address phone:** (574) 546-0654
- **Practice address fax:** (888) 815-1434
- **Mailing address:** 1217 W PLYMOUTH ST, BREMEN, IN 46506-1930
- **Mailing address phone:** (574) 546-0654
- **Mailing address fax:** (888) 815-1434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/14/2022
- **Last updated:** 01/27/2023