Provider Demographics
NPI:1073755658
Name:ABELL, JENILE J (FNP-C)
Entity Type:Individual
Prefix:
First Name:JENILE
Middle Name:J
Last Name:ABELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JENILE
Other - Middle Name:J
Other - Last Name:HARPER-ABELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1210 MEDICAL ARTS BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-3437
Mailing Address - Country:US
Mailing Address - Phone:765-298-4090
Mailing Address - Fax:
Practice Address - Street 1:1210 MEDICAL ARTS BLVD STE 206
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3437
Practice Address - Country:US
Practice Address - Phone:765-298-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002899A363LF0000X
IN28122104A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200946430Medicaid
IN000000637027Medicare PIN