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Individual

GISELLE NEIDANA MARTINEZ NORIEGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
930 MEZZANINE DR, LAFAYETTE, IN 47905-8631
(765) 607-6160
Mailing address
6377 GREEN GRASS LN, WHITESTOWN, IN 46075-9733

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28267646A
IN
363LP2300X
Primary Care Nurse Practitioner
Primary
71015519A
IN

Other

Enumeration date
07/24/2024
Last updated
08/22/2024
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