Individual
ASHTON JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
822 W 1ST ST STE 5, BLOOMINGTON, IN 47403-2382
(317) 957-2110
(317) 957-2050
Mailing address
3403 E RAYMOND ST, INDIANAPOLIS, IN 46203-4782
(317) 957-2000
(317) 957-2050
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
28225235A
IN
363LF0000X
Family Nurse Practitioner
Primary
71012218A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300059357
—
IN
Enumeration date
01/03/2022
Last updated
03/19/2025
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