Provider Demographics
NPI:1326378688
Name:PAPCZYNSKI, ANN MARIE (FNP)
Entity Type:Individual
Prefix:MS
First Name:ANN MARIE
Middle Name:
Last Name:PAPCZYNSKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 #B WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46619
Mailing Address - Country:US
Mailing Address - Phone:574-234-9033
Mailing Address - Fax:
Practice Address - Street 1:1901B W WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46619-3521
Practice Address - Country:US
Practice Address - Phone:574-234-9033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-10
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28112092A163W00000X
IN71003169A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71003169AOtherPRESCRIPTION AUTHORITY