Individual
DIANE ALINE THEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2400 MORTHLAND DR, VALPARAISO, IN 46383-8329
(800) 635-5516
Mailing address
3355 DOUGLAS RD, SUITE 300, SOUTH BEND, IN 46635-1781
(574) 647-1069
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002126A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71002126A
LICENSE #
IN
Enumeration date
09/25/2007
Last updated
07/24/2014
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