Provider Demographics
NPI:1336117001
Name:TRUELOVE, JAMIE R (NP)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:R
Last Name:TRUELOVE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 W LOOMIS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53221-2059
Mailing Address - Country:US
Mailing Address - Phone:414-325-7246
Mailing Address - Fax:414-325-3770
Practice Address - Street 1:4411 WASHINGTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0805
Practice Address - Country:US
Practice Address - Phone:812-437-7246
Practice Address - Fax:812-401-7246
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001429363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
INDN9587OtherRAILROAD MEDICARE GROUP PTAN
INP01074995OtherRAILROAD MEDICARE
IN000000773360OtherANTHEM PROVIDER ID
IN200400000Medicaid
IN200400000Medicaid
INP01074995OtherRAILROAD MEDICARE