Individual
FAWN UPDIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MSN
Contact information
Practice address
1340 RIVERSIDE DR, HUNTINGTON, IN 46750-3524
(812) 371-4311
Mailing address
1340 RIVERSIDE DR, HUNTINGTON, IN 46750-3524
(812) 371-4311
Taxonomy
Speciality
Code
Description
License number
State
163WI0600X
Infection Control Registered Nurse
Primary
28121898A
IN
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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