Individual
KENDALL ILIA-JOAN WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1214 E NATIONAL AVE STE 100, BRAZIL, IN 47834-2700
(812) 442-2820
Mailing address
1214 E NATIONAL AVE STE 100, BRAZIL, IN 47834-2700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71014856A
IN
363LF0000X
Family Nurse Practitioner
Primary
71014856A
IN
Other
Enumeration date
08/17/2017
Last updated
05/14/2024
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