Provider Demographics
NPI:1326005828
Name:CROSS, JENNIFER A (RN, CNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:CROSS
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 SIX PINE RANCH RD
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-9022
Mailing Address - Country:US
Mailing Address - Phone:812-933-6000
Mailing Address - Fax:812-933-6013
Practice Address - Street 1:26 SIX PINE RANCH RD
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-9022
Practice Address - Country:US
Practice Address - Phone:812-933-6000
Practice Address - Fax:812-933-6013
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 132818-COA1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics