Individual
JARA LYNN SOUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
711 E 38TH ST, INDIANAPOLIS, IN 46205-2748
(463) 249-2314
(317) 245-2388
Mailing address
PO BOX 746720, ATLANTA, GA 30374-6720
(312) 733-9730
(773) 866-8014
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
71008724A
IN
207R00000X
Internal Medicine Physician
Primary
F06180782
IN
363LF0000X
Family Nurse Practitioner
Primary
71008724A
IN
Other
Enumeration date
01/10/2019
Last updated
08/03/2026
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