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Individual

DANIELLE M KAMMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
11141 PARKVIEW PLAZA DR STE 305, FORT WAYNE, IN 46845-1715
(260) 266-8900
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71009075A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1102335057
ANTHEM PTAN
IN
Enumeration date
03/22/2019
Last updated
12/05/2024
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