Individual
GLENDA ENSWEILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1919 LAKE AVE STE 106, PLYMOUTH, IN 46563-7830
(574) 335-5220
(574) 335-0859
Mailing address
5215 HOLY CROSS PKWY, MISHAWAKA, IN 46545-1469
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
RN-039913
AZ
363LF0000X
Family Nurse Practitioner
Primary
71006868A
IN
363LF0000X
Family Nurse Practitioner
AP5651
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300057657
—
IN
Enumeration date
08/15/2012
Last updated
01/13/2026
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