Individual
JENNIFER LYNN STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 HENRY ST, NORTH VERNON, IN 47265-1030
(812) 352-4300
Mailing address
301 HENRY ST, NORTH VERNON, IN 47265-1030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01051065A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200173960
—
IN
01
—
DC3600
RAILROAD GROUP
IN
01
—
P00714997
RAILROAD INDIVIDUAL
IN
Enumeration date
11/26/2005
Last updated
08/04/2022
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