Individual
JORDAN R BUSHNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1440 E COUNTY LINE RD, INDIANAPOLIS, IN 46227-0963
(317) 497-6270
Mailing address
1440 E COUNTY LINE ROAD, INDIANAPOLIS, IN 46227
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71007136A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300003636
—
IN
Enumeration date
01/21/2017
Last updated
11/27/2023
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