Individual
REBECCA TARWACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
621 MEMORIAL DR STE 512, SOUTH BEND, IN 46601-1075
(574) 246-9350
Mailing address
51153 PLACID POINTE CT, GRANGER, IN 46530-6557
(574) 210-0551
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71011263A
IN
Other
Enumeration date
07/01/2021
Last updated
07/01/2021
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