Individual
MARY TERESA FOLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 N MAIN ST STE 304, CROWN POINT, IN 46307-1877
(574) 546-1900
(574) 546-1999
Mailing address
PO BOX 10299, FORT WAYNE, IN 46851-0299
(574) 546-1900
(574) 546-1999
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
3013448
KY
363LG0600X
Gerontology Nurse Practitioner
Primary
71009310A
IN
Other
Enumeration date
06/19/2019
Last updated
07/24/2020
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