Individual
JENNIFER VANDIVIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8401 HARCOURT RD, INDIANAPOLIS, IN 46260-2036
(317) 338-4600
Mailing address
8401 HARCOURT RD, INDIANAPOLIS, IN 46260-2036
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71011539A
IN
Other
Enumeration date
09/17/2021
Last updated
08/01/2024
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