Provider Demographics
NPI:1689049421
Name:PEARL, ANN CATHERINE (NP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:CATHERINE
Last Name:PEARL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 E US HIGHWAY 6 STE 330
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-8948
Mailing Address - Country:US
Mailing Address - Phone:219-462-6144
Mailing Address - Fax:219-286-7902
Practice Address - Street 1:85 E US HIGHWAY 6 STE 330
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-8948
Practice Address - Country:US
Practice Address - Phone:219-462-6144
Practice Address - Fax:219-286-7902
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-04
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013490363LF0000X
IN71006828A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily