Black, Jessica Anne
Black, Jessica Anne is an individual health care provider with primary practice located at 9302 N Meridian St Ste 190 , Indianapolis IN 46260-1818. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is her primary health care specialty. Black, Jessica Anne can be contacted via phone (317) 843-1270.Contact Information
Primary practice address
9302 N Meridian St Ste 190
Indianapolis IN 46260-1818
Phone: (317) 843-1270
Fax: (317) 843-4174
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 5296 | North Carolina |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand | 225XH1200X | 5296 | North Carolina |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 31005917A | Indiana |
Profile Details
| NPI number | 1336102607 |
|---|---|
| LBN Legal business name | Black, Jessica Anne |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 8th, 2006 |
| Last updated | Apr 7th, 2016 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336102607 | NPPES |
| Indiana | Other | 555850076 | MEDICARE PTAN |
| Indiana | Other | P00263219 | MEDICARE PTAN |
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