Healthcare Provider Details

I. General information

NPI: 1669386488
Provider Name (Legal Business Name): EVA SELMA JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5760 CAITO DR STE 160
INDIANAPOLIS IN
46226
US

IV. Provider business mailing address

5760 CAITO DR STE 160
INDIANAPOLIS IN
46226
US

V. Phone/Fax

Practice location:
  • Phone: 888-553-5325
  • Fax:
Mailing address:
  • Phone: 888-553-5325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: