Doctor Name: | MARNE J JUESTEL |
NPI Number: | 1245274935 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 71001145B |
Business Practice Address: | 407 W Indiana Ave Chesterton, IN - 463042350 |
Business Phone Number: | 2197638112 |
Business Fax Number: | 2197643251 |
Mailing Address: | Po Box 1430, PORTAGE |
State: | IN |
Postal Code: | 463689230 |
Phone Number: | 2197638112 |
Fax Number: | 2197643251 |
NPI Enumeration Date: | 06/15/2006 |
NPI Last Update Date: | 06/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 71001145B |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |