Individual
EMILY KATHRYN WEATHERHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11050 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1739
(833) 724-8326
(260) 425-6789
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71012116A
IN
Other
Enumeration date
12/14/2021
Last updated
10/15/2022
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