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BILLIE RAE FEDERSPIEL

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
403 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 234-0061
(574) 283-1209
Mailing address
1720 STONECREEK DR, NILES, MI 49120-8686
(269) 683-5745

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71000865A
IN

Other

Enumeration date
02/23/2006
Last updated
07/08/2007
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