Individual
MARISSA E JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7250 CLEARVISTA DR STE 355, INDIANAPOLIS, IN 46256-5609
(317) 621-5676
(317) 621-5678
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7588
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002481A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266180C01
TRADITIONAL MEDICARE
IN
05
—
300016561
—
IN
01
—
P02085718
MEDICARE RAILROAD
IN
Enumeration date
06/14/2018
Last updated
07/24/2023
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