Individual
MRS. EDNA O ISIORHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, APN
Contact information
Practice address
519 OXFORD ST, FORT WAYNE, IN 46806-4177
(260) 745-5161
Mailing address
519 OXFORD ST, FORT WAYNE, IN 46806-4177
(260) 745-5161
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28142963A
IN
163WA2000X
Administrator Registered Nurse
28142963A
IN
163WC0400X
Case Management Registered Nurse
28142963A
IN
163WH0200X
Home Health Registered Nurse
28142963A
IN
Other
Enumeration date
05/26/2010
Last updated
05/26/2010
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