Individual
MARISA LAPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1818 CAREW ST STE 120, FORT WAYNE, IN 46805-4764
(260) 425-6200
Mailing address
3702 NEW VISION DR BLDG B, FORT WAYNE, IN 46845-1703
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28195650A
IN
363L00000X
Nurse Practitioner
Primary
71009288A
IN
Other
Enumeration date
06/07/2019
Last updated
08/30/2019
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