Individual
JEREMY MICHAELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
2323 BROADWAY ST, EAST CHICAGO, IN 46312
(219) 354-8910
(219) 354-0900
Mailing address
1001 STURDY RD, VALPARAISO, IN 46383-4126
(219) 462-7173
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71011400A
IN
Other
Enumeration date
08/03/2021
Last updated
09/22/2022
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