Individual
JASON TREVOR QUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
Mailing address
3848 CONSTITUTION DR, CARMEL, IN 46032-9350
(618) 960-6625
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10004870A
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/05/2025
Last updated
11/28/2025
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