Individual
SONYA ROCQUIL DUBOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
11108 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 266-5700
(260) 266-5910
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
163WC3500X
Cardiac Rehabilitation Registered Nurse
28140329A
IN
363L00000X
Nurse Practitioner
Primary
71013580A
IN
Other
Enumeration date
01/11/2023
Last updated
08/30/2023
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