Individual
JESSICA L GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
8111 S EMERSON AVE, INDIANAPOLIS, IN 46237-8601
(317) 865-5146
(317) 865-5148
Mailing address
PO BOX 778912, CHICAGO, IL 60677-8912
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
28168099A
IN
363LN0000X
Neonatal Nurse Practitioner
Primary
71006273A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201381500
—
IN
Enumeration date
04/20/2016
Last updated
06/13/2023
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