Individual
NADINE L CLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
420 N 26TH ST, LAFAYETTE, IN 47904-2848
(765) 448-8000
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28183832A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71003665A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000731018
ANTHEM PROVIDER NUMBER
IN
05
—
201034120
—
IN
Enumeration date
06/23/2011
Last updated
02/03/2021
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