Individual
MRS. JENNIFER LEIGH DEFAUW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3156 WILLOWCREEK RD, PORTAGE, IN 46368-4498
(219) 762-9444
(219) 762-2288
Mailing address
2753 KERRY DR, VALPARAISO, IN 46385-0031
(219) 331-8183
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71013190A
IN
Other
Enumeration date
09/14/2022
Last updated
06/19/2026
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