Individual
LISA M. FEDDERKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MIDWIFE
Contact information
Practice address
8028 CARNEGIE BLVD STE 300, FORT WAYNE, IN 46804-5788
(260) 425-6650
(260) 755-6233
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
(260) 266-6013
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
09000298
IN
367A00000X
Advanced Practice Midwife
15865NM
OH
Other
Enumeration date
05/14/2014
Last updated
06/04/2024
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