Individual
CARRIE JEAN BOOTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
7910 W JEFFERSON BLVD STE 108, FORT WAYNE, IN 46804-4159
(260) 484-8830
(260) 483-1911
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(239) 236-2775
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71002416A
IN
363LA2200X
Adult Health Nurse Practitioner
71002416A
IN
363LF0000X
Family Nurse Practitioner
Primary
71002416A
IA
Other
Enumeration date
06/25/2007
Last updated
05/15/2025
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