Individual
JOSHUA DANIEL AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
420 W 4TH ST, MISHAWAKA, IN 46544-1948
(574) 307-7673
Mailing address
30613 OAKBROOK DR, GRANGER, IN 46530-5054
(260) 336-2155
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28213722A
IN
Other
Enumeration date
08/18/2020
Last updated
02/24/2021
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