Individual
JENNIFER LYNN MISKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 483-9081
Mailing address
13728 EMPRESS LN, DYER, IN 46311-7069
(219) 627-4354
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71004888A
IN
Other
Enumeration date
12/18/2012
Last updated
08/19/2022
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