Individual
LAURA ANNE DEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
615 N MICHIGAN ST, 1ST FL HOSPITALIST STE, SOUTH BEND, IN 46601-1033
(574) 647-3050
(574) 647-1094
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
71006165A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300011766
—
IN
Enumeration date
05/12/2008
Last updated
04/28/2023
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