Individual
JAMIE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1201 MICHIGAN AVE, SUITE 270, LOGANSPORT, IN 46947-1580
(574) 722-4921
(574) 739-0520
Mailing address
1201 MICHIGAN AVE, SUITE 270, LOGANSPORT, IN 46947-1580
(574) 722-4921
(574) 739-0520
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71004798
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000879689
ANTHEM
IN
05
—
201214700
—
IN
01
—
P01358162
RAILROAD MEDICARE
IN
Enumeration date
02/07/2014
Last updated
04/04/2018
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