Individual
DANIELA M EDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP, NP
Contact information
Practice address
621 MEMORIAL DR STE 502, SOUTH BEND, IN 46601-1075
(574) 647-5875
(574) 647-5878
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
71008852A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300024411
—
IN
Enumeration date
12/06/2018
Last updated
03/14/2024
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