Individual
BRIANNA MAE HOUSEHOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
11104 PARKVIEW CIRCLE DR STE 310, FORT WAYNE, IN 46845-1733
(260) 266-5230
(260) 266-5238
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71014610A
IN
Other
Enumeration date
11/09/2023
Last updated
07/02/2024
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