Bronner, Jessica Sophia

Bronner, Jessica Sophia is an individual health care provider with primary practice located at 1225 E Coolspring Ave Ste 2B , Michigan City IN 46360-6312. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bronner, Jessica Sophia can be contacted via phone (219) 878-5029.

Contact Information

Primary practice address
1225 E Coolspring Ave Ste 2B Michigan City IN 46360-6312
Phone: (219) 878-5029
Fax: (219) 878-8493
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71003880A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 28142364A Indiana

Profile Details

NPI number 1750651188
LBN Legal business name Bronner, Jessica Sophia
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2012
Last updated Apr 14th, 2023 - about last year

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 1750651188 NPPES
Indiana MEDICAID 201068100

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