Individual
EMILY MASTELOU-PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-7001
(260) 435-7632
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0039167
OH
363LN0000X
Neonatal Nurse Practitioner
28230844A
IN
363LN0000X
Neonatal Nurse Practitioner
71010707A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300047177
—
IN
Enumeration date
08/29/2019
Last updated
07/02/2025
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