| Advanced Care Connections Llc | |
|
3010 Independence Dr Fort Wayne IN 46808-1328 | |
| (260) 739-5821 | |
| Not Available |
| Full Name | Advanced Care Connections Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3010 Independence Dr, Fort Wayne, Indiana |
| Authorized Official Name and Position | Melissa Ottenweller (NURSE PRACTITIONER) |
| Authorized Official Contact | 2607395821 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Care Connections Llc 3010 Independence Dr Fort Wayne IN 46808-1328 Ph: () - | Advanced Care Connections Llc 3010 Independence Dr Fort Wayne IN 46808-1328 Ph: (260) 739-5821 |
| NPI Number | 1780059790 |
|---|---|
| Provider Enumeration Date | 12/02/2015 |
| Last Update Date | 01/27/2016 |
| Medicare PECOS PAC ID | 5799080511 |
|---|---|
| Medicare Enrollment ID | O20160216001788 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780059790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Nikki Joy Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336278753 PECOS PAC ID: 3375649254 Enrollment ID: I20070509000748 |
| Provider Name | Victoria Heinen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548234438 PECOS PAC ID: 1850429010 Enrollment ID: I20100507000597 |
| Provider Name | Melissa Sue Ottenweller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881938736 PECOS PAC ID: 6608029020 Enrollment ID: I20130116000169 |
| Provider Name | Linzie Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104473255 PECOS PAC ID: 2163752056 Enrollment ID: I20190918003331 |
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