Individual
MARY A JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
13450 N MERIDIAN ST STE 354, CARMEL, IN 46032-1486
(317) 338-5100
Mailing address
13450 N MERIDIAN ST STE 354, CARMEL, IN 46032-1486
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71000895
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71000895
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200477550
—
IN
Enumeration date
07/27/2007
Last updated
07/06/2022
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