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General NPI Number Information
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NPI Number | 1487650875
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Entity Type | Individual
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Provider Name | MARY HELEN P HAVRAN-ZNAVOR NP
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Gender | Female
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 500 ARCADE AVE STE 400
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City | ELKHART
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State | IN
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Zip | 46514-2487
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Country | US
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Telephone | 574-522-2284
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Fax | 574-522-3952
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Provider Business Mailing Address
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Address Line | 3245 HEALTH DRIVE SUITE 100
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City | GRANGER
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State | IN
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Zip | 46530-3245
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Country | US
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Telephone | 574-647-1840
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704262427
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71001511A
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License Number State | IN
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