Individual
JANET VARDAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
17501 GENERATIONS DR, SOUTH BEND, IN 46635-1589
(574) 234-0049
Mailing address
17501 GENERATIONS DR, SOUTH BEND, IN 46635-1589
(574) 234-0049
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28125272
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200195220
—
IN
Enumeration date
08/15/2006
Last updated
01/14/2015
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