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Anita Louise Doctor, NP
Family Nurse Practitioner in Fort Wayne, Indiana
NPI 1740204270

Anita Louise Doctor is a Family Nurse Practitioner based in Fort Wayne, IN and is specialized in Family. Anita Louise Doctor practices in Fort Wayne, IN and has the professional credentials of NP. The NPI Number for Anita Louise Doctor is 1740204270 and holds a License No. 71002180A (Indiana).

The current practice location address for Anita Louise Doctor is 14303 W Cedar Lake Dr, Fort Wayne, IN and can be reached out via phone at 260-438-8863.

Location: 14303 W Cedar Lake Dr, Fort Wayne, IN, 46845-9642
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1740204270
Provider Name
Anita Louise Doctor
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
14303 W Cedar Lake Dr, Fort Wayne, IN, 46845-9642
Phone Number
260-438-8863
Fax Number
Provider Enumeration Date
07/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000490404 01 IN ANTHEM BLUE CROSS
institution
Provider Business Practice Location Address Details
Address
14303 W Cedar Lake Dr
City
Fort Wayne
State
Indiana
Zip
46845-9642
Phone Number
260-438-8863
Fax Number
person
Provider Business Mailing Address Details
Address
14303 W Cedar Lake Dr
City
Fort Wayne
State
Indiana
Zip
46845-9642
Phone Number
260-438-8863
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
71002180A (Indiana)
Definition
Definition to come...
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