Individual
JILL RENEE CARNAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
7910 W JEFFERSON BLVD STE 212, FORT WAYNE, IN 46804-4159
(260) 427-7473
(260) 432-3189
Mailing address
7910 W JEFFERSON BLVD STE 212, FORT WAYNE, IN 46804-4159
(260) 427-7473
(260) 432-3189
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003973A
IN
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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