Individual
CHANNAH C KLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3371 W CLEVELAND ROAD EXT, SOUTH BEND, IN 46628-9780
(745) 218-6700
(574) 218-6708
Mailing address
1202 E ECKMAN ST, SOUTH BEND, IN 46614-1408
(574) 217-8089
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71006969A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006969A
IN
Other
Enumeration date
03/20/2017
Last updated
06/07/2021
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