Provider Demographics
NPI:1235397100
Name:FRANKLIN, JODIE M (NP)
Entity Type:Individual
Prefix:MRS
First Name:JODIE
Middle Name:M
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:STE 130 PROVIDER ENROLLMENT
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 N. SENATE BLVD.
Practice Address - Street 2:STE 750
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-962-9700
Practice Address - Fax:317-962-9704
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28160951A363LA2200X
IN71002654A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000792104OtherANTHEM
IN201063020Medicaid
IN000000792104OtherANTHEM
INM400068949Medicare PIN