Individual
OPHELIA ANSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4501 LINCONWAY EAST, MISHAWAKA, IN 46544
(866) 389-2727
Mailing address
4501 LINCOLNWAY E, MISHAWAKA, IN 46544-4035
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71006243A
IN
Other
Enumeration date
07/22/2016
Last updated
07/22/2016
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