Individual
JEAN D. ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2516 E DUPONT RD, FORT WAYNE, IN 46825-1608
(260) 434-6076
(260) 489-0833
Mailing address
6920 POINTE INVERNESS WAY STE 200, MEDPARTNERS, ATTN: BARB COPELAND, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000818A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000611224
ANTHEM
IN
05
—
200290830
—
IN
Enumeration date
06/22/2006
Last updated
01/03/2017
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