Individual
MARYLOU CERVANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6050 STERLING CREEK RD, PORTAGE, IN 46368-7752
(219) 763-8112
Mailing address
2665 POPLAR ST, PORTAGE, IN 46368-2940
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71018351A
IN
Other
Enumeration date
07/17/2026
Last updated
07/17/2026
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