Healthcare Provider Details

I. General information

NPI: 1063358547
Provider Name (Legal Business Name): NEFTALI NAVARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54118 BRIDGEWOOD CT
ELKHART IN
46514-6924
US

IV. Provider business mailing address

54118 BRIDGEWOOD CT
ELKHART IN
46514-6924
US

V. Phone/Fax

Practice location:
  • Phone: 574-607-7603
  • Fax:
Mailing address:
  • Phone: 574-607-7603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNONE
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: