Provider Demographics
NPI:1003602848
Name:HOWARD, JASMINE NICOLE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:NICOLE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12368 RUSTIC MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-3850
Mailing Address - Country:US
Mailing Address - Phone:317-965-3518
Mailing Address - Fax:
Practice Address - Street 1:5435 EMERSON WAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-1466
Practice Address - Country:US
Practice Address - Phone:317-362-0293
Practice Address - Fax:317-744-9556
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28260688A163WP0200X
IN71016660A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0200XNursing Service ProvidersRegistered NursePediatrics