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Individual

MARY-KATE OATMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, RN, FNP

Contact information

Practice address
250 E DAY RD, MISHAWAKA, IN 46545
(574) 247-8769
Mailing address
100 WELLNESS CENTER, NOTRE DAME, IN 46556
(574) 292-2935

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704317448
MI
363LF0000X
Family Nurse Practitioner
Primary
71003940A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201069970
IN
01
247000028
MEDICARE PTAN
IN
Enumeration date
02/08/2012
Last updated
02/23/2021
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