Individual
JENNIFER PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
455 S LANDMARK AVE, BLOOMINGTON, IN 47403-5004
(812) 336-5723
Mailing address
455 S LANDMARK AVE, BLOOMINGTON, IN 47403-5004
(812) 336-5723
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
28176666A
IN
363LG0600X
Gerontology Nurse Practitioner
28176666A
IN
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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