Individual
MRS. SUSANA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
621 MEMORIAL DR STE 403, SOUTH BEND, IN 46601-1074
(574) 647-1405
(574) 647-3970
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-3725
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
09000225A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178420006
MEDICARE PTAN
IN
05
—
201132350
—
IN
01
—
236040262
MEDICARE PTAN
IN
Enumeration date
10/31/2012
Last updated
02/20/2026
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