Provider Demographics
NPI:1285692921
Name:JAMES, ANN ELIZABETH (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:ELIZABETH
Last Name:JAMES
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 775383
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-5383
Mailing Address - Country:US
Mailing Address - Phone:812-376-5315
Mailing Address - Fax:
Practice Address - Street 1:4001 W GOELLER BLVD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-8309
Practice Address - Country:US
Practice Address - Phone:812-375-3330
Practice Address - Fax:812-375-3329
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000167363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71000167OtherIN NP LICENSE
IN1285692921OtherNPI
IN051199POtherSIHO
1407861164OtherGROUP NPI
IN201091520Medicaid
IN890000215OtherMEDICARE RAILROAD
IN000000991118OtherANTHEM PIN
IN1285692921OtherNPI
IN000000991118OtherANTHEM PIN
IN201091520Medicaid