Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jefferson Pediatrics, PC

Organization Family Nurse Practitioner · NPI 1134542855

Jefferson Pediatrics, PC is a Family Nurse Practitioner in Fort Wayne, Indiana. Licensed in Indiana. Registered with an NPI since 2014.

Licensed in
IN
In the registry since
2014
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3919 W Jefferson Blvd Ste 1
Fort Wayne, IN 46804-6811
Phone: (260) 436-7722
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 71004759A (IN)

Record details

NPI number1134542855
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Giridhar Veerula — Physician · (260) 436-7722
NPI enumeratedJanuary 31, 2014
Last updated in NPPESJanuary 31, 2014
Mailing address3919 W Jefferson Blvd, Suite 1, Fort Wayne, IN 46804-6811

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