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Individual

DANIEL ROCKWELL TOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSN, FNP

Contact information

Practice address
610 N MICHIGAN ST STE 306, SOUTH BEND, IN 46601-1079
(574) 647-8120
(574) 647-8111
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002775A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20093130
IN
Enumeration date
12/04/2008
Last updated
05/01/2023
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