Individual
LAURA MYERS HIERONYMUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.A.N.P.
Contact information
Practice address
1700 MISHAWAKA AVE, STUDENT ACTIVITY CENTER RM 130, SOUTH BEND, IN 46634-7111
(574) 250-5557
(574) 520-5042
Mailing address
1700 MISHAWAKA AVE, STUDENT ACTIVITY CENTER RM 130, P.O. BOX 7111, SOUTH BEND, IN 46615-1408
(574) 250-5557
(574) 520-5042
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NP02577
OH
Other
Enumeration date
08/15/2007
Last updated
08/15/2007
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