Individual
JAYNE LEE TARGGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
909 TILLER DR, VALPARAISO, IN 46385-1304
(219) 762-6135
Mailing address
909 TILLER DR, VALPARAISO, IN 46385-1304
(219) 762-6135
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002111A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200868760
—
IN
Enumeration date
02/26/2007
Last updated
11/16/2016
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