Organization Name: | LAPORTE REGIONAL PHYSICIAN NETWORK, INC. |
NPI Number: | 1225348733 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RHONDA VOLK (EXECUTIVE VICE-PRESIDENT) |
Mailing Address: | 601 W Kieffer Rd Michigan City |
State: | IN US |
Postal Code: | 463609599 |
Phone Number: | 2198796262 |
Fax Number: | 2198741885 |
NPI Enumeration Date: | 10/18/2010 |
NPI Last Update Date: | 10/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 71003388 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |