Brodhead, Jerica Nichole

Brodhead, Jerica Nichole is an individual health care provider with primary practice located at 7250 Clearvista Dr Ste 355, Indianapolis IN 46256-4692. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Brodhead, Jerica Nichole can be contacted via phone (317) 621-5676.

Contact Information

Primary practice address
7250 Clearvista Dr Ste 355 Indianapolis IN 46256-4692
Phone: (317) 621-5676
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10001219A Indiana

Profile Details

NPI number 1043504285
LBN Legal business name Brodhead, Jerica Nichole
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2011
Last updated Dec 19th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043504285 NPPES
Indiana Other 1487680518 GROUP NPI
Indiana Other 000000741701 GROUP NPI

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