Individual
KAITLIN JASMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1400 N RITTER AVE, SUITE 375B, INDIANAPOLIS, IN 46219-3052
(317) 621-2740
(317) 355-8751
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001629A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01291704
RAILROAD MEDICARE
IN
Enumeration date
01/24/2014
Last updated
12/03/2014
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