Individual
JESSICA J POLISKIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9669 E 146TH ST, SUITE 250, NOBLESVILLE, IN 46060-5005
(317) 621-9926
(317) 621-9676
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
(317) 621-7588
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01075392A
IN
207Q00000X
Family Medicine Physician
11016690A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201099650
—
IN
01
—
P01599192
RR MEDICARE
IN
Enumeration date
03/26/2012
Last updated
11/27/2023
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