Organization Name: | CARDINAL ELEMENTS INC |
NPI Number: | 1659780708 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARY ANN WIETBROCK (CLINICAL NURSE SPECIALIST) |
Mailing Address: | 4108 W 400 S New Palestine |
State: | IN US |
Postal Code: | 461639612 |
Phone Number: | 3174109140 |
Fax Number: | |
NPI Enumeration Date: | 08/02/2014 |
NPI Last Update Date: | 08/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC1500X |
License Number: | 28088637A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |