MAPLE LEAF PAIN RELIEF NPI 1114469277

NPI Information

  • NPI: 1114469277
  • Provider Name: MAPLE LEAF PAIN RELIEF
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Address: 908 E IRELAND RD
    SOUTH BEND, IN
    ZIP 46614
  • Phone: (214) 284-1420

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NPI Details

MAPLE LEAF PAIN RELIEF is a family nurse practitioner in South Bend, IN. MAPLE LEAF PAIN RELIEF NPI is 1114469277. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

908 E IRELAND RD
SOUTH BEND, IN
ZIP 46614-664
Phone: (214) 284-1420

The provider's authorized official is Shannon Roberts .
The authorized official title is Owner and has the following contact phone number (214) 284-1420.

The enumeration date for this NPI number is 11/7/2016 and was last updated on 11/7/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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