Provider Demographics
NPI:1104991637
Name:OHMS, JEWELL ANN (CRNP-CDE)
Entity type:Individual
Prefix:
First Name:JEWELL
Middle Name:ANN
Last Name:OHMS
Suffix:
Gender:F
Credentials:CRNP-CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PENNSYLVANIA PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46280-1393
Mailing Address - Country:US
Mailing Address - Phone:317-581-2006
Mailing Address - Fax:
Practice Address - Street 1:201 PENNSYLVANIA PKWY STE 310
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46280-1393
Practice Address - Country:US
Practice Address - Phone:317-843-0000
Practice Address - Fax:317-968-1183
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH284585363LC1500X
IN28113704A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
INMO6581854OtherDEA