Individual provider · NPI-1

Ophelia Ansari

Nurse Practitioner, Family · Mishawaka, IN

NPI number1760835912
StatusActive
Last updated in NPPESJul 22, 2016

Details

NPI
1760835912
Entity type
Individual (NPI-1)
Name
Ophelia Ansari
Sex
Female
Sole proprietor
No
Enumeration date
Jul 22, 2016
Last updated
Jul 22, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family71006243AINYes

Practice location

4501 Linconway East
Mishawaka, IN 46544

Phone 866-389-2727

Mailing address

4501 Lincolnway E
Mishawaka, IN 46544-4035

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