MARA NICOLE HUMBERG NP
Individual Provider (NPI-1)
Active
Nurse Practitioner, Pediatrics
Provider Information
- NPI Number
1760089445- Provider Type
- Individual Provider (NPI-1)
- Credentials
- NP
- Status
- Active
Contact & Location
- Address
- 2316 SOUTH ST, LAFAYETTE, IN, 479042971
- Phone
- (765) 742-1567
- Fax
- (765) 742-2750
Specialties & Taxonomies
Nurse Practitioner, Pediatrics
Primary License: IN #71011419A
Registered Nurse
License: IN #28224434A