Doctor Name: | MARY-KATE OATMAN |
NPI Number: | 1326310160 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSN, RN, FNP |
License Number: | 4704317448 |
Business Practice Address: | 12340 Bittersweet Commons Blvd W Granger, IN - 465306959 |
Business Phone Number: | 5742718610 |
Business Fax Number: | |
Mailing Address: | 710 N Niles Ave, SOUTH BEND |
State: | IN |
Postal Code: | 466171924 |
Phone Number: | 5746471610 |
Fax Number: | |
NPI Enumeration Date: | 02/08/2012 |
NPI Last Update Date: | 06/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704317448 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |