Provider Demographics
NPI:1902334659
Name:CIELO, JESSICA L (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:CIELO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 W RAMPART ST STE 160
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-8845
Mailing Address - Country:US
Mailing Address - Phone:317-392-2971
Mailing Address - Fax:317-398-1894
Practice Address - Street 1:30 W RAMPART ST STE 160
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-8845
Practice Address - Country:US
Practice Address - Phone:317-392-2971
Practice Address - Fax:317-398-1894
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28216483A163W00000X
IN71007183A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse