Individual
PATRICIA A WANGERIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
761 45TH STREET, STE. 103, MUNSTER, IN 46321
(219) 922-3002
(219) 922-3003
Mailing address
757 45TH STREET, STE. 201, MUNSTER, IN 46321
(219) 922-5550
(219) 922-5555
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000554A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200286340A
—
IN
Enumeration date
06/07/2006
Last updated
10/27/2011
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