Provider Demographics
NPI:1598325763
Name:HULTS, JESSICA MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MARIE
Last Name:HULTS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11103 PEPPERMILL LN
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9082
Mailing Address - Country:US
Mailing Address - Phone:317-372-8015
Mailing Address - Fax:
Practice Address - Street 1:9202 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1800
Practice Address - Country:US
Practice Address - Phone:317-841-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18004162A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist