Provider Demographics
NPI:1467077578
Name:MATUSHEK, JORI DANAE (NP)
Entity Type:Individual
Prefix:MRS
First Name:JORI
Middle Name:DANAE
Last Name:MATUSHEK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JORI
Other - Middle Name:DANAE
Other - Last Name:FELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8402 HARCOURT RD STE 300
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2052
Mailing Address - Country:US
Mailing Address - Phone:317-338-3100
Mailing Address - Fax:317-338-2692
Practice Address - Street 1:8402 HARCOURT RD STE 300
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2052
Practice Address - Country:US
Practice Address - Phone:317-388-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28236821A363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics