Individual
JENNA N TREADWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
701 E COUNTY LINE RD STE 101, GREENWOOD, IN 46143-1070
(317) 885-2860
(317) 885-2869
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
28178949A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71006323A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201381360
—
IN
Enumeration date
06/23/2016
Last updated
02/19/2025
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