Individual
DR. JERWANA LASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
10935 BEECHWOOD DR E, INDIANAPOLIS, IN 46280-1222
(317) 441-1093
(317) 669-2739
Mailing address
10935 BEECHWOOD DR E, INDIANAPOLIS, IN 46280-1222
(317) 441-1093
(317) 669-2739
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
07001149A
IN
213EP1101X
Primary Podiatric Medicine Podiatrist
794
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07001149B
IN LICENSE
IN
01
—
794
TN LICENSE
TN
Enumeration date
09/05/2012
Last updated
10/12/2016
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