Most Relevant Information
Provider Data
| NPI Number: | 1003510157 |
| Provider Name: | TAMMY MOEHLE |
| Entity Type: | Individual |
| Taxonomy Code: | 163WX0200X |
| Specialty: | Registered Nurse |
| License Number: | 28158466A |
Most Important Dates
| Enumeration Date: | 03/30/2023 |
| Last Updated: | 03/30/2023 |
Provider Practice Location
2121 LAKE AVE
FORT WAYNE
IN
468055100
Practice Location Phone/Fax
| Phone: | 2604265431 |
| Fax: |
Provider Mailing Location
2121 LAKE AVE
FORT WAYNE
IN
468055100
Provider Mailing Phone/Fax
| Phone: | 2603485080 |
| Fax: |