Individual
REBECCA MAHLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
600 EAST BLVD, ELKHART, IN 46514-2499
(574) 294-2621
Mailing address
50667 HAVEN HILL DR, GRANGER, IN 46530-6635
(574) 261-2753
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28185974A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
28185974A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300051643
—
IN
Enumeration date
05/06/2021
Last updated
05/12/2025
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