Provider Demographics
NPI:1619237476
Name:ARCHER, JANE (FNP)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:ARCHER
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5650 S FRANKLIN RD STE 300C
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-8620
Mailing Address - Country:US
Mailing Address - Phone:317-245-7353
Mailing Address - Fax:317-527-9214
Practice Address - Street 1:5650 S FRANKLIN RD STE 300C
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-8620
Practice Address - Country:US
Practice Address - Phone:317-245-7353
Practice Address - Fax:317-527-9214
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN28146547AOtherREGISTERED NURSE LICENSE