Individual
JESSICA MARIE BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP - C
Contact information
Practice address
400 N MOUNT ZION RD, LEBANON, IN 46052-9497
(765) 335-0123
(765) 335-0127
Mailing address
2605 N LEBANON ST, LEBANON, IN 46052-1476
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28202210A
IN
363LF0000X
Family Nurse Practitioner
Primary
71009049A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300034867
—
IN
Enumeration date
06/10/2019
Last updated
10/16/2023
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