Individual
JENNIFER NICOLE EAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 554-0000
Mailing address
6709 CRIMSON KING CT, INDIANAPOLIS, IN 46256-3261
(317) 407-9233
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002580A
IN
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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