Individual
DR. JENNIFER ANN CODDINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, MSN, RN, CPNP
Contact information
Practice address
502 N UNIVERSITY ST, JOHNSON HALL RM B-5, WEST LAFAYETTE, IN 47907-2069
(765) 494-6341
(765) 496-1022
Mailing address
502 N UNIVERSITY ST, JOHNSON HALL RM B-5, WEST LAFAYETTE, IN 47907-2069
(765) 494-6341
(765) 496-1022
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71000722A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000351155
ANTHEM PROVIDER NUMBER
IN
05
—
200299820
—
IN
01
—
9397700
PHCS PID NUMBER
IN
Enumeration date
03/20/2006
Last updated
08/06/2009
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