Individual
MRS. DAPHNE PONTIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN WHNP-BC
Contact information
Practice address
621 MEMORIAL DR STE 403, SOUTH BEND, IN 46601-1074
(574) 647-1405
(574) 647-3970
Mailing address
216 S 3RD AVE, WAUSAU, WI 54401-4636
(800) 246-5743
(715) 675-1819
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
71012429A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300061190
—
IN
Enumeration date
06/29/2020
Last updated
11/01/2023
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