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Individual

JENNIFER LYNN BALSAMELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 880-6560
(317) 880-0333
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71011183A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
71011183A
LICENSE
IN
Enumeration date
06/14/2021
Last updated
01/31/2025
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