Individual
JESSIKA A FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1402 E COUNTY LINE RD, INDIANAPOLIS, IN 46227
(317) 887-7805
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7588
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71008007A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300014638
—
IN
01
—
P02078322
MEDICARE RAIDROAD
IN
Enumeration date
06/07/2018
Last updated
10/26/2018
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