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CARRIE B PRICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
(260) 436-8585
Mailing address
PO BOX 2526, FORT WAYNE, IN 46801-2526
(260) 436-8686
(260) 436-8585

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003963A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000911955
ANTHEM
05
0066704
OH
05
201071630
IN
01
PO1445373
RAILROAD MEDICARE
IN
Enumeration date
04/24/2012
Last updated
08/14/2024
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