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General NPI Number Information
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NPI Number | 1962919076
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Entity Type | Individual
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Provider Name | JILL I COSS NP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 714 N SENATE AVE STE 200
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-3297
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Country | US
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Telephone | 317-963-1616
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Fax | 317-963-1621
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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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 |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71007731A
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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 | 71007731A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28189022A
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License Number State | IN
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