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Individual

MRS. JULIE ANNE PASTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
420 W 4TH ST, MISHAWAKA, IN 46544-1948
(574) 307-7685
(574) 307-7692
Mailing address
420 W 4TH ST, MISHAWAKA, IN 46544-1948
(574) 307-7685
(574) 307-7692

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71007447A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
236040469
MEDICARE
IN
05
300069384
IN
Enumeration date
09/07/2017
Last updated
12/08/2023
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