| Kiersa Diane Durfee, MD | |
|
420 N Sawyer Rd, Kendallville, IN 46755-2572 | |
| (260) 347-8030 | |
| (260) 347-8035 |
| Full Name | Kiersa Diane Durfee |
|---|---|
| Gender | Female |
| Speciality | Obstetrics & Gynecology |
| Location | 420 N Sawyer Rd, Kendallville, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972793800 | NPI | - | NPPES |
| 48292 | Other | FL | BLUE CROSS/BLUE SHIELD |
| 000114200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 01072818A (Indiana) | Primary |
| Entity Name | Healthnet Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780634964 PECOS PAC ID: 7214840933 Enrollment ID: O20031110000227 |
| Entity Name | Iu Health Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326893777 PECOS PAC ID: 9638617913 Enrollment ID: O20240817000533 |
| Mailing Address | Practice Location Address |
|---|---|
| Kiersa Diane Durfee, MD 11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701 Ph: () - | Kiersa Diane Durfee, MD 420 N Sawyer Rd, Kendallville, IN 46755-2572 Ph: (260) 347-8030 |
Luis M Velasco, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 420 N Sawyer Rd, Kendallville, IN 46755 Phone: 260-347-8030 Fax: 260-347-8035 | |
Rhonda Miller, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 420 N Sawyer Rd, Kendallville, IN 46755 Phone: 260-347-8030 Fax: 260-347-8035 | |
Bobby Tolosa, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 420 N Sawyer Rd, Kendallville, IN 46755 Phone: 260-347-8030 Fax: 260-347-8035 |