Individual
MRS. DEBORAH ANN BARESIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
7910 W JEFFERSON BLVD, STE 301, FORT WAYNE, IN 46804-4159
(260) 432-6250
(260) 432-6077
Mailing address
6705 WOODCREST DR, FORT WAYNE, IN 46815-5568
(260) 485-6428
(260) 436-7220
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
71000624A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71000624A
NURSE PRACTITIONER LICENS
IN
Enumeration date
05/04/2007
Last updated
07/08/2007
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