Individual
MS. JILL J NEWCOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
500 ARCADE AVE, SUITE 400, ELKHART, IN 46514-2487
(574) 522-2284
(574) 522-3952
Mailing address
3245 HEALTH DRIVE, SUITE 100, GRANGER, IN 46530-3245
(574) 647-1840
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71003312A
IN
363LF0000X
Family Nurse Practitioner
71003312A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200999010
—
IN
Enumeration date
08/23/2010
Last updated
04/28/2023
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