Provider Demographics
NPI:1699017343
Name:PARKER METTER, JESSICA ELLEN (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ELLEN
Last Name:PARKER METTER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ELLEN
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:535 BARNHILL DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5116
Practice Address - Country:US
Practice Address - Phone:317-944-8231
Practice Address - Fax:317-948-7900
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR3730207VX0201X
IN01086288A207VX0201X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000001612936OtherANTHEM PTAN
IN1102241023OtherANTHEM PTAN
IN300057189Medicaid