Individual
MRS. LAURA WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2824 ELKHART RD, GOSHEN, IN 46526-1014
(574) 295-7178
Mailing address
2824 ELKHART RD, GOSHEN, IN 46526-1014
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000844A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000532188
ANTHEM
—
05
—
200272820
—
IN
Enumeration date
02/07/2006
Last updated
01/18/2021
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