Individual
JASON D. HAVIZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1801 N SENATE BLVD STE 2000, INDIANAPOLIS, IN 46202-1252
(317) 962-8700
(317) 962-9704
Mailing address
1801 N SENATE BLVD STE 2000, INDIANAPOLIS, IN 46202-1252
(317) 962-8700
(317) 962-9704
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28216219A
IN
363LF0000X
Family Nurse Practitioner
71009383A
IN
363LG0600X
Gerontology Nurse Practitioner
28216219A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71009383A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300030817
—
IN
Enumeration date
09/23/2019
Last updated
05/22/2025
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