Individual
JAN VANDER LUITGAREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5897 SHALLOW WATER LN, BARGERSVILLE, IN 46106-8521
(317) 410-0319
Mailing address
5897 SHALLOW WATER LN, BARGERSVILLE, IN 46106-8521
(317) 410-0319
Taxonomy
Speciality
Code
Description
License number
State
163WN1003X
Nutrition Support Registered Nurse
Primary
28133402A
IN
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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