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Individual

ANITA LYNN ALCORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1500 PROVIDENT DR STE A, WARSAW, IN 46580-3297
(574) 372-7637
Mailing address
1275 PROVIDENT DR, WARSAW, IN 46580-3265
(574) 269-4026

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28095409A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200482650
IN
Enumeration date
06/15/2006
Last updated
09/14/2020
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