Individual
JACQUELINE WENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5908 E STOP 11 RD, INDIANAPOLIS, IN 46237-8683
(317) 497-6800
(317) 497-6801
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/08/2015
Last updated
11/27/2023
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