Provider Demographics
NPI:1851964894
Name:NOVINA, DRAGANA
Entity Type:Individual
Prefix:
First Name:DRAGANA
Middle Name:
Last Name:NOVINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 MURVIHILL RD
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-5960
Mailing Address - Country:US
Mailing Address - Phone:219-286-3907
Mailing Address - Fax:219-286-3911
Practice Address - Street 1:3000 MURVIHILL RD
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-5960
Practice Address - Country:US
Practice Address - Phone:219-286-3907
Practice Address - Fax:219-286-3911
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28231829A163W00000X
IN71011334A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse