Individual
MARY VERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
(574) 272-9000
Mailing address
9102 MORRAINE HILLS RD, MICHIGAN CITY, IN 46360-9409
(219) 873-4116
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28086350A
IN
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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