Provider Demographics
NPI:1184169591
Name:HALLINAN, JENNIFER LEE (RN, BSN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:HALLINAN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 RILEY HOSPITAL DR RM 5880
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5109
Mailing Address - Country:US
Mailing Address - Phone:317-948-7324
Mailing Address - Fax:317-948-7577
Practice Address - Street 1:1002 WISHARD BLVD STE 3120
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2872
Practice Address - Country:US
Practice Address - Phone:317-948-7324
Practice Address - Fax:317-948-7577
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28167055A163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management