Individual
JAQUAN JAMAK CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6030 E STATE BLVD, FORT WAYNE, IN 46815-7639
(260) 452-0554
(260) 246-6374
Mailing address
6030 E STATE BLVD, FORT WAYNE, IN 46815-7639
(260) 452-0554
(260) 246-6374
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/06/2026
Last updated
04/06/2026
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