Individual
MS. JENNIFER JOY GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
206 S UNION ST, KOKOMO, IN 46901-4606
(765) 457-4673
Mailing address
8840 COMMERCE PARK PL STE E, INDIANAPOLIS, IN 46268-3129
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001719A
IN
363LA2200X
Adult Health Nurse Practitioner
71001719A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200475100
—
IN
Enumeration date
04/04/2006
Last updated
08/03/2016
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