Individual
MRS. FERN O MCHENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 483-9081
(260) 483-9196
Mailing address
PO BOX 392552, PITTSBURGH, PA 15251-9500
(260) 483-9081
(260) 483-9196
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71000956A
IN
363LF0000X
Family Nurse Practitioner
Primary
71000956A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200324220
—
IN
Enumeration date
09/01/2006
Last updated
09/19/2019
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