Individual
MARLISE ANN WEBBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1815 E IRELAND RD, SOUTH BEND, IN 46614-2845
(574) 647-1750
(574) 647-1748
Mailing address
3245 HEALTH DRIVE, SUITE 100, GRANGER, IN 46530-1380
(574) 647-1840
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28192631A
IN
363L00000X
Nurse Practitioner
Primary
71010638A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300045313
—
IN
Enumeration date
11/03/2020
Last updated
10/16/2024
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