Healthcare Provider Details

I. General information

NPI: 1003602848
Provider Name (Legal Business Name): JASMINE NICOLE HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5435 EMERSON WAY
INDIANAPOLIS IN
46226-1466
US

IV. Provider business mailing address

12368 RUSTIC MEADOW DR
INDIANAPOLIS IN
46229-3850
US

V. Phone/Fax

Practice location:
  • Phone: 317-362-0293
  • Fax: 317-744-9556
Mailing address:
  • Phone: 317-965-3518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number28260688A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71016660A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: