Individual
JOSIAH WESLEY REISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPNP-AC
Contact information
Practice address
7613 W JEFFERSON BLVD STE 200, FORT WAYNE, IN 46804-4182
(260) 469-7337
(260) 469-7340
Mailing address
7613 W JEFFERSON BLVD STE 200, FORT WAYNE, IN 46804-4182
(260) 469-7337
(260) 469-7340
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71010368A
IN
Other
Enumeration date
09/09/2020
Last updated
09/14/2020
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