Individual
JENNIE MAGUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1310 S LEBANON ST, LEBANON, IN 46052-2792
(765) 482-7005
Mailing address
1310 S LEBANON ST, LEBANON, IN 46052-2792
(765) 482-7005
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71000209A
IN
Other
Enumeration date
09/17/2015
Last updated
03/23/2021
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