Glass, Jaci R
Glass, Jaci R is an individual health care provider with primary practice located at 1199 Hadley Rd Ste 100 , Mooresville IN 46158-1788. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Glass, Jaci R can be contacted via phone (317) 834-3263.Contact Information
Primary practice address
1199 Hadley Rd Ste 100
Mooresville IN 46158-1788
Phone: (317) 834-3263
Fax: (317) 834-5194
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 28174021A | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 71003660A | Indiana |
Profile Details
| NPI number | 1326320656 |
|---|---|
| LBN Legal business name | Glass, Jaci R |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2011 |
| Last updated | Jul 31st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326320656 | NPPES |
| Indiana | MEDICAID | 201035270 |
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