MEDICARE: JENNIFER JOY HUISMAN NP

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	71001495A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942214010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER JOY HUISMAN NP

Provider Business Mailing Address
First Line	:	4808 VIKING TRL
Second Line	:
City	:	NEW CASTLE
State	:	IN
Zip	:	47362-8810
Country	:	US
Telephone Number	:	765-836-5400
Fax Number	:	765-836-5400

Provider Business Practice Location Address
First Line	:	4808 VIKING TRL
Second Line	:
City	:	NEW CASTLE
State	:	IN
Zip	:	47362-8810
Country	:	US
Telephone Number	:	765-836-5400
Fax Number	:	765-836-5400

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/09/2007

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