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NPI 1548214109

NPI 1548214109 : MARY ESTHER ELIAS NP : FORT WAYNE, IN

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General NPI Number Information
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    NPI Number           |    1548214109
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    Entity Type          |    Individual 
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    Provider Name        |    MARY ESTHER ELIAS NP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/19/2006
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    Last Update Date     |    11/18/2025
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Provider Practice Location Address
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    Address Line         |    9821 LIMA RD 
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    City                 |    FORT WAYNE
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    State                |    IN
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    Zip                  |    46818-8656
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    Country              |    US
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    Telephone            |    260-240-5027
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    Fax                  |    260-209-5119
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Provider Business Mailing Address
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    Address Line         |    250 N SHADELAND AVE 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46219-4959
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    Country              |    US
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    Telephone            |    
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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        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    ARNP3351692
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    License Number State |    FL
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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       |    71001971A
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    License Number State |    IN
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