Healthcare Provider Details

I. General information

NPI: 1417812041
Provider Name (Legal Business Name): HEALTH IN FAITH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9421 ACACIA PSGE
FORT WAYNE IN
46835-9101
US

IV. Provider business mailing address

9421 ACACIA PSGE
FORT WAYNE IN
46835-9101
US

V. Phone/Fax

Practice location:
  • Phone: 260-255-4601
  • Fax: 260-202-5601
Mailing address:
  • Phone: 260-255-4601
  • Fax: 260-202-5601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BERNADETTE GRAY
Title or Position: OWNER/PRESIDENT
Credential: FNP-BC
Phone: 260-255-4601