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General NPI Number Information
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NPI Number | 1174440549
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Entity Type | Organization
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Legal Business Name | 41 HEALTH COLLECTIVE LLC
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 1870 W HOOSIER BLVD
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City | PERU
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State | IN
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Zip | 46970-3643
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Country | US
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Telephone | 765-271-8414
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Fax |
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Provider Business Mailing Address
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Address Line | 1870 W HOOSIER BLVD
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City | PERU
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State | IN
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Zip | 46970-3643
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NP/MANAGING MEMBER
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Name | JESSIE MYERS
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Credential | NP
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Telephone | 765-271-8414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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