Individual
JEREMY JACK HEADLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1220 N LAKEVIEW CIR APT G, FRANKLIN, IN 46131-8841
(317) 642-6097
Mailing address
1220 N LAKEVIEW CIR APT G, FRANKLIN, IN 46131-8841
(317) 642-6097
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
28214884A
IN
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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