Individual
JAY LEE HOEKSEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
661 E MAIN ST, PERU, IN 46970-2662
(765) 472-2519
(765) 400-4465
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1335
(317) 343-6562
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71010433A
IN
363LF0000X
Family Nurse Practitioner
28160280A
IN
363LF0000X
Family Nurse Practitioner
Primary
71010433A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28160280A
REG. NURSING
IN
01
—
71010433A
APRN PRESCRIPTIVE AUTHORITY
IN
01
—
71010433B
CSR PRESCRIPTIVE AUTHORITY
IN
Enumeration date
10/05/2020
Last updated
09/23/2024
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