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NPI Code Detail

MEDICARE: HEALTHCARE PRACTITIONERS INC

MEDICARE: HEALTHCARE PRACTITIONERS INC
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
1363LA2200XAdult Health Nurse Practitioner71001142AIN

General Provider Information

NPI Number : 1982887402
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHCARE PRACTITIONERS INC
Provider Business Mailing Address
First Line : PO BOX 15753
Second Line :
City : FORT WAYNE
State : IN
Zip : 46885-5753
Country : US
Telephone Number : 269-450-3096
Fax Number :
Provider Business Practice Location Address
First Line : 1010 W WASHINGTON CENTER RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-4155
Country : US
Telephone Number : 260-489-2552
Fax Number :
Authorized Official
Title or Position : OWNER
Name : CAROLINE MATVYA
Credential : NURSE PRACTITIONER
Telephone Number : 269-450-3096
Provider Enumeration Date : 12/06/2007
Last Update Date : 12/06/2007

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