Individual
ELIZABETH ANN VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3325 WILLOWCREEK RD, PORTAGE, IN 46368-5015
(219) 850-4490
Mailing address
711 BLANEY DR, DYER, IN 46311-2306
(219) 677-4917
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28174919A
IN
363LF0000X
Family Nurse Practitioner
Primary
71013178A
IN
Other
Enumeration date
10/11/2022
Last updated
08/15/2024
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