MEDICARE: JANA STEDMAN PA-C

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	363A00000X	Physician Assistant	10002344A	IN
2	363A00000X	Physician Assistant	085005550	IL

General Provider Information

NPI Number	:	1205210861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA STEDMAN PA-C

Provider Business Mailing Address
First Line	:	PO BOX 3231
Second Line	:
City	:	MUNSTER
State	:	IN
Zip	:	46321-0231
Country	:	US
Telephone Number	:	219-200-2022
Fax Number	:

Provider Business Practice Location Address
First Line	:	8063 MADISON AVE # 527
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-6001
Country	:	US
Telephone Number	:	219-200-2022
Fax Number	:

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

Provider Enumeration Date	:	07/14/2015
Last Update Date	:	07/04/2024

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Directions to “ JANA STEDMAN PA-C” Practice Location

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