MEDICARE: JESSICA E KLIPSCH RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	71016955A	IN
2	163W00000X	Registered Nurse	28160333A	IN

General Provider Information

NPI Number	:	1033211040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA E KLIPSCH RN

Provider Business Mailing Address
First Line	:	3400 LAFAYETTE RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-1146
Country	:	US
Telephone Number	:	317-291-7422
Fax Number	:	317-291-7433

Provider Business Practice Location Address
First Line	:	3400 LAFAYETTE RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-1146
Country	:	US
Telephone Number	:	317-291-7422
Fax Number	:	317-291-7433

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	04/03/2026

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Directions to “ JESSICA E KLIPSCH RN” Practice Location

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