Individual
JONATHAN TODD AGEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
8320 MADISON AVE, SUITE H, INDIANAPOLIS, IN 46227-6066
(317) 381-5252
(317) 859-5304
Mailing address
200E FAIRMAN AVE, WATSEKA, IL 60970-1644
(765) 969-3678
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000676A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200489910
—
IN
Enumeration date
04/16/2007
Last updated
12/21/2015
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