Individual
NANETTE NELL MCKIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Mailing address
110 SPRING FOREST CT, FORT WAYNE, IN 46804-6721
(260) 257-9295
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
28115626A
IN
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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