Healthcare Provider Details

I. General information

NPI: 1326464561
Provider Name (Legal Business Name): BARBARA J. DWARS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2014
Last Update Date: 03/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 JACKSON ST. EADS ELEMENTARY SCHOOL
MUNSTER IN
46321
US

IV. Provider business mailing address

8616 COLUMBIA AVE. SCHOOL TOWN OF MUNSTER
MUNSTER IN
46321
US

V. Phone/Fax

Practice location:
  • Phone: 219-836-8635
  • Fax: 219-836-3217
Mailing address:
  • Phone: 219-836-9111
  • Fax: 219-836-3215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28092876A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: