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Individual

CAROLE A TENGBLAD

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1190 N STATE ROAD 49, PORTER, IN 46304-1368
(219) 926-2146
(219) 926-3721
Mailing address
1190 N STATE ROAD 49, PORTER, IN 46304-1368
(219) 926-2146
(219) 926-3721

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001223A
IN

Other

Enumeration date
07/20/2005
Last updated
07/08/2007
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