Individual
HNIN NWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3501 WARSAW ST, FORT WAYNE, IN 46806-4175
(260) 458-2641
Mailing address
4118 NANTUCKET DR, FORT WAYNE, IN 46815-5623
(260) 312-6202
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28231273A
IN
363L00000X
Nurse Practitioner
Primary
71016166A
IN
Other
Enumeration date
11/18/2024
Last updated
04/22/2026
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