Individual
JOELYNN BIGHEART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2787 EMERSON ST, PORTAGE, IN 46368-3305
(219) 512-8214
Mailing address
2787 EMERSON ST, PORTAGE, IN 46368-3305
(219) 512-8214
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27065113A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51-0137391
—
IN
Enumeration date
04/25/2018
Last updated
04/25/2018
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