Individual
KARA A HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3512 STELLHORN RD, FORT WAYNE, IN 46815
(260) 483-9081
(260) 483-9196
Mailing address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 483-9081
(260) 483-9196
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71008154A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/18/2018
Last updated
07/26/2018
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