Bult, Jodi

Bult, Jodi is an individual health care provider with primary practice located at 15900 W 101St Ave , Dyer IN 46311-3065. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Bult, Jodi can be contacted via phone (219) 365-6333.

Contact Information

Primary practice address
15900 W 101St Ave Dyer IN 46311-3065
Phone: (219) 365-6333
Fax: (219) 365-8291
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 071004325A Indiana

Profile Details

NPI number 1669447900
LBN Legal business name Bult, Jodi
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Apr 8th, 2021 - about 5 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 1669447900 NPPES
Indiana MEDICAID 200424880A

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