Healthcare Provider Details

I. General information

NPI: 1134553357
Provider Name (Legal Business Name): JESSICA R RAMER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2013
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3916 S CALHOUN ST
FORT WAYNE IN
46807-2408
US

IV. Provider business mailing address

3702 NEW VISION DR STE B
FORT WAYNE IN
46845-1703
US

V. Phone/Fax

Practice location:
  • Phone: 260-298-6240
  • Fax:
Mailing address:
  • Phone: 260-266-8210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71009911
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: