| Doctor Name: | MRS. JESSICA RUTH BLEYLE |
| NPI Number: | 1053703900 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 71005373A |
| Business Practice Address: | 1466 W Oak St Zionsville, IN - 460771800 |
| Business Phone Number: | 3178736438 |
| Business Fax Number: | |
| Mailing Address: | 7720 Bancaster Dr, INDIANAPOLIS |
| State: | IN |
| Postal Code: | 462685710 |
| Phone Number: | 3175173515 |
| Fax Number: | |
| NPI Enumeration Date: | 03/02/2015 |
| NPI Last Update Date: | 03/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 71005373A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |