Individual
CRYSTAL MAGGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8175 W US HIGHWAY 20, SHIPSHEWANA, IN 46565-9169
(260) 768-7432
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71006403A
IN
363LF0000X
Family Nurse Practitioner
28157248A
IN
Other
Enumeration date
06/24/2016
Last updated
10/08/2022
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