JEFFERSON PEDIATRICS PC NPI 1134542855

NPI Information

NPI: 1134542855
Provider Name: JEFFERSON PEDIATRICS, PC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
3919 W JEFFERSON BLVD
SUITE 1
FORT WAYNE, IN
ZIP 46804
Phone: (260) 436-7722
Get Directions

JEFFERSON PEDIATRICS, PC is a family nurse practitioner in Fort Wayne, IN. JEFFERSON PEDIATRICS, PC NPI is 1134542855. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3919 W JEFFERSON BLVD
SUITE 1
FORT WAYNE, IN
ZIP 46804-811
Phone: (260) 436-7722

The provider's authorized official is Giridhar Veerula .
The authorized official title is Physician and has the following contact phone number (260) 436-7722.

The enumeration date for this NPI number is 1/31/2014 and was last updated on 1/31/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	71004759A	INDIANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »