Individual
SHERE LYNN MAZUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 460-1347
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 460-1347
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
28106785A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28106785A
REGISTERED NURSE
IN
Enumeration date
06/05/2022
Last updated
06/05/2022
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