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NPI Code Detail

MEDICARE: LEEANN MARIE ENIX NP

MEDICARE:   LEEANN MARIE ENIX  NP
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 Practitioner71008878AIN

General Provider Information

NPI Number : 1306360227
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEEANN MARIE ENIX NP
Provider Business Mailing Address
First Line : 3245 HEALTH DR STE 100
Second Line :
City : GRANGER
State : IN
Zip : 46530-1380
Country : US
Telephone Number : 574-647-2129
Fax Number : 269-408-4269
Provider Business Practice Location Address
First Line : 206 W WARREN ST
Second Line :
City : MIDDLEBURY
State : IN
Zip : 46540-9410
Country : US
Telephone Number : 574-358-0042
Fax Number : 574-358-0157
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2017
Last Update Date : 12/09/2025

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