Jefferis, Jeanette P

Jefferis, Jeanette P is an individual health care provider with primary practice located at 1050 Wishard Blvd 4Th Fl, Indianapolis IN 46202-2872. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Jefferis, Jeanette P can be contacted via phone (317) 630-7979.

Contact Information

Primary practice address
1050 Wishard Blvd 4Th Fl Indianapolis IN 46202-2872
Phone: (317) 630-7979
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71000204A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 71000204A Indiana

Profile Details

NPI number 1851342190
LBN Legal business name Jefferis, Jeanette P
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Feb 22nd, 2012 - 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 1851342190 NPPES
Indiana MEDICAID 200173570

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