Individual
AMANJIT KAUR BANWAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3909 NEW VISION DR, FORT WAYNE, IN 46845-1725
(260) 425-5500
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28235280A
IN
363L00000X
Nurse Practitioner
Primary
71013149A
IN
Other
Enumeration date
08/31/2022
Last updated
03/23/2023
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