Individual
JEAN RENE MBASSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1522 W MORRIS ST, INDIANAPOLIS, IN 46221-1629
(317) 957-2500
Mailing address
3908 MEADOWS DR STE C, INDIANAPOLIS, IN 46205-3114
(317) 957-2000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71007963A
IN
363LF0000X
Family Nurse Practitioner
AP-60600744
WA
363LF0000X
Family Nurse Practitioner
CNP-02800
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300015032
—
IN
Enumeration date
12/24/2015
Last updated
05/04/2026
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