Individual
ELLEN HENNESSY-HARSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
9128 COLUMBIA AVE, MUNSTER, IN 46321-2907
(219) 836-2730
(219) 836-0244
Mailing address
9128 COLUMBIA AVE, MUNSTER, IN 46321-2907
(219) 836-2730
(219) 836-0244
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71000811A
IN
Other
Enumeration date
05/28/2008
Last updated
05/28/2008
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