Organization
DEDICATED FAMILY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLETTE H WALTER NP (NP, CEO)
(219) 509-3383
Entity
Organization
Contact information
Practice address
117 N MAIN ST, HEBRON, IN 46341-8971
(219) 509-3383
(219) 509-3389
Mailing address
117 N MAIN ST, HEBRON, IN 46341-8971
(219) 509-3383
(219) 509-3389
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144797986
NPI 2
IN
05
—
201180370
—
IN
Enumeration date
10/30/2018
Last updated
04/16/2019
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