Healthcare Provider Details

I. General information

NPI: 1205167566
Provider Name (Legal Business Name): JAMIE BROOKS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2010
Last Update Date: 04/13/2020
Certification Date: 04/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1466 W OAK ST
ZIONSVILLE IN
46077-1800
US

IV. Provider business mailing address

6549 BRIARWOOD PL
ZIONSVILLE IN
46077-8541
US

V. Phone/Fax

Practice location:
  • Phone: 317-873-6438
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2011002627
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9202508
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71007230A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: