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General NPI Number Information
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NPI Number | 1275348815
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Entity Type | Individual
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Provider Name | JESSICA LYNNE BOFFING RN
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Gender | Female
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 395 WESTFIELD RD
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City | NOBLESVILLE
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State | IN
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Zip | 46060-1425
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Country | US
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Telephone | 317-385-7121
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Fax |
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Provider Business Mailing Address
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Address Line | 12186 EVERWOOD CIR
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City | NOBLESVILLE
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State | IN
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Zip | 46060-4179
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Country | US
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Telephone | 317-385-7121
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 28261617A
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License Number State | IN
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