Individual
MARLISE FLETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10620 CORPORATE DR STE A, FORT WAYNE, IN 46845-1711
(260) 423-2567
(260) 420-2415
Mailing address
10620 CORPORATE DR STE A, FORT WAYNE, IN 46845-1711
(260) 423-2567
(260) 420-2415
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000262A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200273770A
—
IN
Enumeration date
04/22/2006
Last updated
02/19/2015
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