Individual
JENNIFER LEE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(888) 484-3258
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71010270A
IN
363LF0000X
Family Nurse Practitioner
Primary
71010270A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264431088
MEDICARE PTAN
IN
01
—
267030328
MEDICARE PTAN
IN
05
—
300041636
—
IN
01
—
M12240434
MEDICARE PTAN
IN
Enumeration date
07/20/2020
Last updated
02/18/2025
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