# JONATHAN NOTELLE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1982061701
- **Gender:** Man
- **Credential:** ARNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 28202205A | IN | — |
| 363L00000X | Nurse Practitioner | 71006122A | IN | Yes |

## Other

- **Enumeration date:** 01/25/2016
- **Last updated:** 08/14/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1003883 | BCBS | IN |
| 05 | — | 201350810 | — | IN |