Healthcare Provider Details

I. General information

NPI: 1306503834
Provider Name (Legal Business Name): JENAE JONES PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9245 N MERIDIAN ST STE 300
INDIANAPOLIS IN
46260-1832
US

IV. Provider business mailing address

9245 N MERIDIAN ST STE 300
INDIANAPOLIS IN
46260-1832
US

V. Phone/Fax

Practice location:
  • Phone: 317-818-9000
  • Fax: 317-818-9009
Mailing address:
  • Phone: 317-818-9000
  • Fax: 317-818-9009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71012015A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number28219264A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: