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Individual

MRS. ROSE M EWING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528
(574) 753-7541
Mailing address
1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528
(574) 753-7541

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000503A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000881719
ANTHEM
IN
05
200229210
IN
Enumeration date
07/18/2005
Last updated
11/04/2014
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