Healthcare Provider Details

I. General information

NPI: 1336117001
Provider Name (Legal Business Name): JAMIE R TRUELOVE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 WASHINGTON AVE STE 100
EVANSVILLE IN
47714-0805
US

IV. Provider business mailing address

4131 W LOOMIS RD STE 300
GREENFIELD WI
53221-2059
US

V. Phone/Fax

Practice location:
  • Phone: 812-437-7246
  • Fax: 812-401-7246
Mailing address:
  • Phone: 414-325-7246
  • Fax: 414-325-3770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71001429
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: