Individual
ADDISEN MARIE PRATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7970 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-6100
Mailing address
4527 JOSHUA CT, WEST LAFAYETTE, IN 47906-8670
(765) 427-5702
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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