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Individual

CARY LYNN MALSTAFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1007 LINCOLNWAY, LA PORTE, IN 46350-3201
(219) 326-2300
Mailing address
109 GRISSOM DR, WALKERTON, IN 46574-1002
(574) 309-6226

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
281506A
IN
363LF0000X
Family Nurse Practitioner
Primary
71007185A
IN

Other

Enumeration date
06/26/2017
Last updated
06/26/2017
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