Organization
NES OF SANDUSKY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MOORE (CFO)
(415) 435-4591
Entity
Organization
Contact information
Practice address
1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528
(574) 753-7541
Mailing address
PO BOX 31118, BELFAST, ME 04915-0140
(800) 377-8721
(304) 697-1155
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/08/2015
Last updated
05/17/2022
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