Individual
KORTNEY MICHELLE DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
11104 PARKVIEW CIRCLE DR STE 20, FORT WAYNE, IN 46845-1733
(260) 266-2500
(260) 266-2514
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71011300A
IN
Other
Enumeration date
07/23/2021
Last updated
04/20/2023
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