Provider Demographics
NPI:1891420535
Name:TODD, JESSI (NP)
Entity Type:Individual
Prefix:
First Name:JESSI
Middle Name:
Last Name:TODD
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 1:972 EMERSON PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-6202
Mailing Address - Country:US
Mailing Address - Phone:317-279-5166
Mailing Address - Fax:
Practice Address - Street 1:HENDRICKS BEHAVIORAL HOSPITAL
Practice Address - Street 2:1051 SOUTHFIELD DRIVE
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168
Practice Address - Country:US
Practice Address - Phone:844-991-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2023-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71012937A363LP0808X, 363LP0808X
IN28195272A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty