Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 08002704A | IN |
N | 111NN1001X | Nutrition | 08002704A | IN |
N | 111NP0017X | Pediatric Chiropractor | 08002704A | IN |
NPI | 1083044713 |
---|---|
Provider Name | Dr. Jessica Stuaan |
First Address | Carmel, IN 46032-2995 |
Second Address | Carmel, IN 46032-2995 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2013 |
Last Update Date | 18/11/2013 |