Provider Demographics
NPI:1194714287
Name:ARNETT, JENNIFER A (RNC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:ARNETT
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:SPENCER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5150 SHELBYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237
Mailing Address - Country:US
Mailing Address - Phone:317-782-1577
Mailing Address - Fax:317-780-5539
Practice Address - Street 1:5150 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237
Practice Address - Country:US
Practice Address - Phone:317-782-1577
Practice Address - Fax:317-780-5539
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001538A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200522370AMedicaid
IN200522370AMedicaid