Individual
JOLYNNE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
130 PROFESSIONAL CT, SUITE D, LAFAYETTE, IN 47905-5153
(765) 446-8888
(765) 446-8889
Mailing address
780 N AUDUBON RD, INDIANAPOLIS, IN 46219-5822
(317) 370-2170
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
.71005973A
IN
363LG0600X
Gerontology Nurse Practitioner
71005973A
IN
Other
Enumeration date
12/31/2015
Last updated
07/27/2016
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