Individual
MARY BEENA MAMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3505 S REED RD, KOKOMO, IN 46902-3838
(765) 453-8666
Mailing address
3505 S REED RD, KOKOMO, IN 46902-3838
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71008081A
IN
Other
Enumeration date
07/05/2018
Last updated
07/05/2018
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