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1699318899
JACOB GREGORY HUSEMAN
EAST CHICAGO, IN
NPI
1699318899
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: IN 71009696A)
Enumeration Date
2019-10-21
Last Update Date
2020-12-07
Business Address
Mr. JACOB GREGORY HUSEMAN
4321 FIR ST
EAST CHICAGO, IN 46312-3049
Phone number: 219-703-1764
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Mailing Address
Mr. JACOB GREGORY HUSEMAN
4321 FIR ST
EAST CHICAGO, IN 46312-3049
Phone number: 219-331-9169
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