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Individual

JENNIFER THOMASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
649 N 200 E, VALPARAISO, IN 46383-9711
(219) 728-8223
Mailing address
649 N 200 E, VALPARAISO, IN 46383-9711
(219) 728-8223

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041401225
IL
363LF0000X
Family Nurse Practitioner
209024505
IL
363LF0000X
Family Nurse Practitioner
Primary
71013308A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041401225
RPN LICENSE
IL
Enumeration date
12/07/2021
Last updated
12/04/2024
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