Individual
JASON SOULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
2340 E 10TH ST, INDIANAPOLIS, IN 46201-2008
(317) 957-2200
Mailing address
3403 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
(317) 957-2000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71008585A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300021150
—
IN
Enumeration date
09/08/2018
Last updated
02/07/2022
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