Individual
JENNY RAE YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN ASN
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 554-0000
Mailing address
565 PELENOR DR, FRANKLIN, IN 46131-8926
(317) 702-0842
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28195417A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28195417A
NURSING BOARD
IN
Enumeration date
09/19/2022
Last updated
09/19/2022
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