Healthcare Provider Details

I. General information

NPI: 1649933656
Provider Name (Legal Business Name): JO ANNA FRANCES CURLESS WHNP, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JO ANNA FRANCES LIVERGOOD

II. Dates (important events)

Enumeration Date: 10/17/2021
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NAVARRE PL STE 4470
SOUTH BEND IN
46601
US

IV. Provider business mailing address

BEACON MEDICAL GROUP, INC 3245 HEALTH DRIVE STE 100
GRANGER IN
46530-1380
US

V. Phone/Fax

Practice location:
  • Phone: 574-647-1405
  • Fax: 574-647-3970
Mailing address:
  • Phone: 574-647-3437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number71015319A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: