Individual
DONNA HALES-TEAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1915 LAKE AVE, PLYMOUTH, IN 46563-9366
(574) 948-4000
Mailing address
25425 ALFONSA DR, SOUTH BEND, IN 46619-9705
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28176875C
IN
Other
Enumeration date
05/28/2024
Last updated
06/28/2024
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