Individual
CARRIE Y YUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
621 MEMORIAL DR STE 100, SOUTH BEND, IN 46601-1063
(574) 647-1100
(574) 647-5907
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003476A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300057763
—
IN
Enumeration date
08/30/2021
Last updated
03/28/2025
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