Provider Demographics
NPI:1336550813
Name:BINHACK, JO
Entity type:Individual
Prefix:
First Name:JO
Middle Name:
Last Name:BINHACK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JODY
Other - Middle Name:
Other - Last Name:BINHACK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4818 VICTORIA RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46228-2125
Mailing Address - Country:US
Mailing Address - Phone:317-590-7131
Mailing Address - Fax:
Practice Address - Street 1:4818 VICTORIA RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46228-2125
Practice Address - Country:US
Practice Address - Phone:317-590-7131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28074601A163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine