Individual
TESSA MAE STOMBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
8436 ARDENNES DR, FISHERS, IN 46038-4406
(317) 407-4969
Mailing address
8436 ARDENNES DR, FISHERS, IN 46038-4406
(317) 407-4969
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.478085
IL
163W00000X
Registered Nurse
28213983A
IN
367A00000X
Advanced Practice Midwife
Primary
09000312A
IN
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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