Individual
JESSICA D BODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1130 MEDICAL ARTS BLVD STE 250, ANDERSON, IN 46011-3431
(765) 298-4282
(765) 298-4989
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
28150756A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300035751
—
IN
Enumeration date
12/04/2019
Last updated
11/27/2023
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