Individual
CHARISSE L PRALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11143 PARKVIEW PLAZA DR STE 100, FORT WAYNE, IN 46845-1728
(260) 484-8830
Mailing address
11143 PARKVIEW PLAZA DR STE 100, FORT WAYNE, IN 46845-1728
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28173869A
IN
363LF0000X
Family Nurse Practitioner
Primary
71007582A
IN
Other
Enumeration date
08/29/2017
Last updated
12/30/2025
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