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Contact Information

LISA M FEDDERKE, MIDWIFE
8028 CARNEGIE BLVD STE 300
FORT WAYNE, IN46804-5788
 Phone: 260-425-6650
 Fax: 260-755-6233
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Advanced Practice Midwife

367A00000X 42 Certified Nurse Midwife
Indicates primary specialty

NPI Profile & details for LISA M FEDDERKE · (Female)

NPI # 1134530967
Status Active
Credentials MIDWIFE
Entity Individual
Enumeration date 05/14/2014
Last updated 06/04/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IN License # 09000298
  • OH License # 15865NM
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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