Allen, Jodi A

Allen, Jodi A is an individual health care provider with primary practice located at 11161 Randolph St , Crown Point IN 46307-8564. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Allen, Jodi A can be contacted via phone (219) 662-9424.

Contact Information

Primary practice address
11161 Randolph St Crown Point IN 46307-8564
Phone: (219) 662-9424
Fax: (219) 662-7465
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71003739A Indiana

Profile Details

NPI number 1558646091
LBN Legal business name Allen, Jodi A
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2011
Last updated Dec 11th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558646091 NPPES
Indiana Other 000000745867 ANTHEM TRADITIONAL, BLUE ACCESS, PPO
Indiana MEDICAID 201040780 ANTHEM TRADITIONAL, BLUE ACCESS, PPO

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