Jennifer Lynn Miskov, NP-C
Nurse Practitioner, Family in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1114263233
StatusActive
Last updated in NPPESAug 19, 2022
Details
- NPI
- 1114263233
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Lynn Miskov
- Credential
- NP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 18, 2012
- Certification date
- Aug 17, 2022
- Last updated
- Aug 19, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 71004888A | IN | Yes |
Practice location
3512 Stellhorn RdFort Wayne, IN 46815-4631
Phone 260-483-9081
Mailing address
13728 Empress LnDyer, IN 46311-7069
Phone 219-627-4354
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