Individual
GINA THORNTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1004 PARKWAY AVE STE B, ELKHART, IN 46516-9349
(574) 226-0626
Mailing address
51905 COPPERFIELD CV, GRANGER, IN 46530-5080
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71014540A
IN
Other
Enumeration date
10/26/2023
Last updated
11/29/2023
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