Individual
MRS. DARYL GENE NANALE MAGADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4160
(260) 435-7001
(260) 434-6456
Mailing address
5001 BUELL DR, FORT WAYNE, IN 46807-3205
(714) 814-4832
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
28243886A
IN
363LA2100X
Acute Care Nurse Practitioner
Primary
71012804A
IN
363LC0200X
Critical Care Medicine Nurse Practitioner
71012804A
IN
Other
Enumeration date
07/14/2022
Last updated
07/18/2022
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