Individual
ABAGAIL BOOKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2121 LAKE AVENUE, FORT WAYNE, IN 46805
(260) 426-5431
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27065833A
IN
Other
Enumeration date
03/01/2024
Last updated
03/01/2024
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