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General NPI Number Information
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NPI Number | 1841287299
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Entity Type | Individual
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Provider Name | NANCY JANE PAUNICKA RN MS-FNP-CS
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Gender | Female
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 3777 NORTH FRONTAGE ROAD
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City | MICHIGAN CITY
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State | IN
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Zip | 46360-7694
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Country | US
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Telephone | 219-877-3880
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Fax | 219-879-6365
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Provider Business Mailing Address
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Address Line | PO BOX 1690
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City | LA PORTE
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State | IN
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Zip | 46352-1690
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Country | US
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Telephone | 219-326-2312
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Fax | 219-326-2584
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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 | 71000141A
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License Number State | IN
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