Individual
MRS. JENNIFER CAROL FANCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
709 PLAZA DR STE 1, CHESTERTON, IN 46304-1573
(219) 728-6091
(877) 793-9750
Mailing address
104 W 700 N, VALPARAISO, IN 46385-8581
(219) 309-0034
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28174733A
IN
Other
Enumeration date
12/12/2022
Last updated
12/12/2022
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