Provider Demographics
NPI:1750578720
Name:INBODY, JEAN ANN (NP)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:ANN
Last Name:INBODY
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 1:2405 W LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-1417
Mailing Address - Country:US
Mailing Address - Phone:574-295-8805
Mailing Address - Fax:574-522-0039
Practice Address - Street 1:2405 W LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-1417
Practice Address - Country:US
Practice Address - Phone:574-295-8805
Practice Address - Fax:574-522-0039
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28050806A363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology