Individual
LAURA KANYIMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
610 N MICHIGAN ST STE 400, SOUTH BEND, IN 46601-1081
(574) 647-8120
(574) 647-8111
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-2129
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71015198A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300092847
—
IN
Enumeration date
05/06/2024
Last updated
07/19/2024
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