Individual
MRS. STEPHANIE L KEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC, CNOR
Contact information
Practice address
11108 PARKVIEW CIRCLE DR., SUITE 5100, FORT WAYNE, IN 46845-1707
(260) 266-2800
(260) 266-2805
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002980A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000667885
ANTHEM
IN
05
—
200951030
—
IN
Enumeration date
07/17/2009
Last updated
10/20/2022
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