NPI 1013045855

Jackie Lynn Boatman

Practitioner Specialist Brownsburg, IN

Practice location

Address: 219 Brooks Bnd, Brownsburg, IN 46112-9235
Phone: (317) 858-8130
Fax: (317) 858-8130

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 311447 (IN)

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Registry record

NPI: 1013045855
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Mar 2007
Record last updated: 9 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.