Individual
MIYAKO S STREETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
31 SIBLEY ST STE A, HAMMOND, IN 46320
(219) 802-8800
Mailing address
31 SIBLEY ST STE A, HAMMOND, IN 46320-1725
(219) 802-8800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209.017998
IL
363LF0000X
Family Nurse Practitioner
Primary
041358443
IL
363LF0000X
Family Nurse Practitioner
71008683A
IN
Other
Enumeration date
01/11/2019
Last updated
08/01/2023
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