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General NPI Number Information
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NPI Number | 1912695362
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Entity Type | Individual
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Provider Name | ROSARIO MEZA NP-C
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Gender | Female
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Dates
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Enumeration Date | 04/25/2023
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 4900 E 107TH CT
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City | WINFIELD
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State | IN
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Zip | 46307-2862
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Country | US
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Telephone | 219-472-0309
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Fax | 219-472-0089
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Provider Business Mailing Address
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Address Line | 3435 172ND ST
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City | HAMMOND
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State | IN
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Zip | 46323-2810
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Country | US
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Telephone | 219-680-8936
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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 | 71013873A
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License Number State | IN
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