Individual
TARA L VOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1104 N WAYNE ST, NORTH MANCHESTER, IN 46962-1001
(260) 982-2102
(260) 982-2105
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71004675A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000839126
ANTHEM
—
05
—
201213800
—
IN
Enumeration date
09/06/2011
Last updated
10/10/2022
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