MEDICARE: ANN ELIZABETH JAMES NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	71000167	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	890000215	OTHER	IN	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	71000167	OTHER	IN	IN NP LICENSE
2	1285692921	OTHER	IN	NPI
3	051199P	OTHER	IN	SIHO
4	1407861164	OTHER		GROUP NPI
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	000000991118	OTHER	IN	ANTHEM PIN

General Provider Information

NPI Number	:	1285692921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN ELIZABETH JAMES NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	PO BOX 775383
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-5383
Country	:	US
Telephone Number	:	812-376-5315
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 W GOELLER BLVD STE A
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-8309
Country	:	US
Telephone Number	:	812-375-3330
Fax Number	:	812-375-3329

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	09/09/2024

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