Individual provider · Type 1 NPI

Jackie Suzanne Tank, PA

Physician Assistant · Indianapolis, IN

NPI number 1043854409 Active

Practice location

5255 E Stop 11 Rd Ste 450
Indianapolis, IN 46237-6342

Call (317) 865-4800 Map

Fax (317) 865-4806

Mailing address

PO Box 781076
Detroit, MI 48278-1076

Other practice locations

  • 200 High Service Ave, North Providence, RI 02904-5113 · (401) 456-3000
  • 825 Chalkstone Ave, Providence, RI 02908-4728 · (401) 456-2000

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Physician Assistant Primary 363A00000X10002853A (IN)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1043854409

Jackie Suzanne Tank, PA's National Provider Identifier is 1043854409, issued on Oct 29, 2019. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Indianapolis, IN. The record was last updated on May 5, 2026.