Provider Demographics
NPI:1649933656
Name:CURLESS, JO ANNA FRANCES (WHNP, IBCLC)
Entity type:Individual
Prefix:
First Name:JO ANNA
Middle Name:FRANCES
Last Name:CURLESS
Suffix:
Gender:F
Credentials:WHNP, IBCLC
Other - Prefix:
Other - First Name:JO ANNA
Other - Middle Name:FRANCES
Other - Last Name:LIVERGOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:BEACON MEDICAL GROUP, INC
Mailing Address - Street 2:3245 HEALTH DRIVE STE 100
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-1380
Mailing Address - Country:US
Mailing Address - Phone:574-647-3437
Mailing Address - Fax:
Practice Address - Street 1:100 NAVARRE PL STE 4470
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601
Practice Address - Country:US
Practice Address - Phone:574-647-1405
Practice Address - Fax:574-647-3970
Is Sole Proprietor?:No
Enumeration Date:2021-10-17
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71015319A363LW0102X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300094996Medicaid