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Individual

JODI A ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
11161 RANDOLPH ST, CROWN POINT, IN 46307-8564
(219) 662-9424
(219) 662-7465
Mailing address
1040 SIERRA DR, SUITE 400, GREENWOOD, IN 46143-7241
(317) 528-4284
(317) 865-8355

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003739A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000745867
ANTHEM TRADITIONAL, BLUE ACCESS, PPO
IN
05
201040780
IN
Enumeration date
10/17/2011
Last updated
12/11/2013
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