Individual
JORDEN ROSE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8402 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2006
(317) 338-7674
Mailing address
8402 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2006
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10003302A
IN
363AS0400X
Surgical Physician Assistant
Primary
10003302A
IN
Other
Enumeration date
08/02/2021
Last updated
06/28/2023
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