IndividualActive
Theresa Roth, RN
NPI 1194886697 · Adult Psychiatric/Mental Health Registered Nurse · Fort Wayne, IN
Provider details
- NPI number
- 1194886697
- Entity type
- Individual
- Primary specialty
- Adult Psychiatric/Mental Health Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- License
- 28112127A (IN)
Practice location
909 E State Blvd
Fort Wayne, IN 46805-3404
Phone: (260) 481-2700
Fax: (260) 481-2717
Mailing address
909 E State Blvd
Fort Wayne, IN 46805-3404
Registry dates
- Enumerated
- 2006-12-12
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.