Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 28113704A | IN |
N | 363LC1500X | Nurse Practitioner - Community Health | 284585 | OH |
NPI | 1104991637 |
---|---|
Provider Name | Jewell Ann Ohms |
First Address | Carmel, IN 46280-1393 |
Second Address | Carmel, IN 46280-1393 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 31/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MO6581854 | DEA (01) | IN |