Jennifer Lynn Cicchiello, MSN, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Madison, IN
NPI 1629209028 · NPPES record last updated Oct 24, 2013
Key facts
- NPI
- 1629209028
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71003589A (IN)
- Practice address
- 311 E Clifty Dr
Madison, IN 47250-4621 - Phone
- (812) 274-2742
- NPI assigned
- Aug 3, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71003589A | IN | MD | Family Nurse Practitioner |
| 6117P | KY | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 6117P | KY | |
| Family Nurse Practitioner | 363LF0000X | 71003589A | IN | Yes |
Addresses
Primary practice location
311 E Clifty Dr
Madison, IN 47250-4621
Mailing address
PO Box 979
Madison, IN 47250-0979
Phone (812) 274-2742
Other names
- Mrs. Jennifer Lynn Beal
Other providers in Madison, IN
- CFD LLC
- Connie Thompson Chambers
- Mark Leon Charpentier
- Tiffany Lynn Chisholm
- Virginia Louise Christie
- Molly Michelle Cissell
- Clifty Counseling LLC
- Clifty Falls Chiropractic Center, P.S.C.
- Devin Nicole Cline
- Brittany K. Cole
All providers in Madison, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.