Individual
JENNIFER J PELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8607 E US HIGHWAY 36 STE 100, AVON, IN 46123-7960
(317) 745-5403
Mailing address
8607 E US HIGHWAY 36 STE 100, AVON, IN 46123-7960
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
28182943A
IN
363L00000X
Nurse Practitioner
Primary
71010653A
IN
363LF0000X
Family Nurse Practitioner
71010653A
IN
Other
Enumeration date
11/03/2020
Last updated
03/04/2024
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