Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 01050890A | IN |
NPI | 1003817297 |
---|---|
Provider Name | Dr. Jodie R Harper |
First Address | Indianapolis, IN 46260-2103 |
Second Address | Indianapolis, IN 46260-2103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 25/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000368689 | ANTHEM (01) | IN |
200361260A | (05) | IN |
H54341 | (02) | IN |