Most Relevant Information
Provider Data
| NPI Number: | 1003501255 |
| Provider Name: | MARY VERNON |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 28086350A |
Most Important Dates
| Enumeration Date: | 04/05/2023 |
| Last Updated: | 04/05/2023 |
Provider Practice Location
1540 TRINITY PL
MISHAWAKA
IN
465455006
Practice Location Phone/Fax
| Phone: | 5742729000 |
| Fax: |
Provider Mailing Location
9102 MORRAINE HILLS RD
MICHIGAN CITY
IN
463609409
Provider Mailing Phone/Fax
| Phone: | 2198734116 |
| Fax: |