Individual
FELICIA ANNE COLCLESSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5909 ILLINOIS RD, FORT WAYNE, IN 46804-1159
(260) 432-6026
Mailing address
4131 N WASHINGTON RD, FORT WAYNE, IN 46804-1821
(260) 436-7255
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001217B
IN
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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