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NPI Code Detail

MEDICARE: MARNE J JUESTEL FNP

MEDICARE: MARNE J JUESTEL FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner71001145AIN
2363L00000XNurse Practitioner71001145AIN

General Provider Information

NPI Number : 1245274935
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARNE J JUESTEL FNP
Provider Business Mailing Address
First Line : 457 HIGHLAND DR
Second Line :
City : PORTER
State : IN
Zip : 46304-2265
Country : US
Telephone Number : 219-916-4936
Fax Number :
Provider Business Practice Location Address
First Line : 9660 WICKER AVE
Second Line :
City : SAINT JOHN
State : IN
Zip : 46373-9487
Country : US
Telephone Number : 219-365-1177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 01/18/2022

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Directions to “ MARNE J JUESTEL FNP” Practice Location

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