Individual
JESSICA A HAISLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8075 N SHADELAND AVE, STE 200, INDIANAPOLIS, IN 46250-2693
(317) 621-8500
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001561A
IN
363AM0700X
Medical Physician Assistant
085-002611
IL
Other
Enumeration date
08/18/2006
Last updated
06/11/2021
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