Individual
JENI SYLESE GRUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-3959
Mailing address
3553 WINDHAM LAKE TRCE, INDIANAPOLIS, IN 46214-1469
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AG07170084
IN
Other
Enumeration date
09/28/2017
Last updated
09/28/2017
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