Jerica Nichole Brodhead PA-C

NPI 1043504285 - Physician Assistant - 363A00000X

NPI Details
NPI 1043504285
Gender Female
Enumeration Date 06/06/2011
Last Updated 05/03/2012
Entity Type Individual
Active Over 6 years ago
Practice Location
18051 RIVER AVE
SUITE 202
NOBLESVILLE IN, 46062-7091, US
Phone (317) 773-6106
Fax (317) 773-6158
Business Location
679 E COUNTY LINE RD
GREENWOOD IN, 46143-1049, US
Phone (317) 807-1262
Fax (317) 859-4268
Toxanomy
Taxonomy Code 363A00000X
License State Indiana
License Number 10001219A
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According to our database, Mrs. Jerica Nichole Brodhead PA-C NPI is 1043504285, taxonomy code is 363A00000X and license number is 10001219A, license state is located at Indiana. Jerica Nichole Brodhead PA-C physically located at 18051 River Ave, Noblesville IN, 46062-7091. NPI Number Jerica Nichole Brodhead PA-C has the Individual type.

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1043504285 NPI number is provided on an as is basis without warranty of any kind. 1043504285 is maintained by the National Plan & Provider Enumeration System. The contents of Jerica Nichole Brodhead PA-C are for informational purposes only.