Individual
JENNIFER LYNN RITCHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7956 W JEFFERSON BLVD, FORT WAYNE, IN 46804
(260) 436-2416
(260) 436-9662
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
20874
TN
363LF0000X
Family Nurse Practitioner
Primary
71006580A
IN
363LF0000X
Family Nurse Practitioner
901429
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102230040
ANTHEM PTAN
IN
05
—
201395000
—
IN
01
—
IN4866046
MEDICARE PTAN
IN
Enumeration date
01/28/2016
Last updated
09/16/2024
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