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General NPI Number Information
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NPI Number | 1356998710
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Entity Type | Individual
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Provider Name | JENNIFER M OKEEFE NP
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Gender | Female
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Dates
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Enumeration Date | 08/21/2019
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 2100 N MAIN ST STE 304
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City | CROWN POINT
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State | IN
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Zip | 46307-1877
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Country | US
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Telephone | 574-546-1900
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Fax | 574-546-1999
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Provider Business Mailing Address
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Address Line | 2100 N MAIN ST STE 304
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City | CROWN POINT
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State | IN
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Zip | 46307-1877
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Country | US
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Telephone | 574-546-1900
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Fax | 574-546-1999
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 28208903A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704362899
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN.CNP.0027228
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 71009467A
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License Number State | IN
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