Organization
CONNIE S CARUNCHIA PROFESSIONAL CORPORATION
Active
Other names
Connie S. Herron, PC
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE S. COLE NP-C (PRESIDENT/OWNER)
(260) 349-8185
Entity
Organization
Contact information
Practice address
5900 E 500 N, KENDALLVILLE, IN 46755-9349
(260) 349-8185
(888) 347-0088
Mailing address
5900 E 500 N, KENDALLVILLE, IN 46755-9349
(260) 349-8185
(888) 347-0088
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
55000068A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201023750A
—
IN
01
—
DS6979
RR MEDICARE
—
Enumeration date
06/02/2011
Last updated
08/04/2014
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