NPI 1053143164

Brianna Latisnere-Blosser

Practitioner Physician Assistant Goshen, IN

Practice location

Address: 2006 S Main St STE a, Goshen, IN 46526-5232
Phone: (574) 535-9100
Fax: (574) 535-1020

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 10004633A (IN)

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Registry record

NPI: 1053143164
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Aug 2024
Record last updated: 7 Nov 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.