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Individual

AUDREY OTTENWELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2700 LAFAYETTE ST STE 110, FORT WAYNE, IN 46806-1100
(260) 266-0780
Mailing address
12523 CHAPELWOOD PL, FORT WAYNE, IN 46845-6931
(260) 402-9369

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28298451A
IN

Other

Enumeration date
11/04/2025
Last updated
11/04/2025
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