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Individual

KENDRA DE VRIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
503 OTIS BOWEN DR, MUNSTER, IN 46321-4158
(219) 703-5152
Mailing address
503 OTIS BOWEN DR, MUNSTER, IN 46321-4158

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28204066A
IN
363LF0000X
Family Nurse Practitioner
Primary
71009822A
IN

Other

Enumeration date
01/02/2020
Last updated
02/20/2020
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