Corban, Jena M
Corban, Jena M is an individual health care provider with primary practice located at 270 E Day Rd Suite 280, Mishawaka IN 46545-3444. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Corban, Jena M can be contacted via phone (574) 231-6190.Contact Information
Primary practice address
270 E Day Rd Suite 280
Mishawaka IN 46545-3444
Phone: (574) 231-6190
Fax: (574) 247-1012
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 7100148A | Indiana |
Profile Details
| NPI number | 1134129919 |
|---|---|
| LBN Legal business name | Corban, Jena M |
| Credentials | Master of Science in Nursing (MSN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 22nd, 2005 |
| Last updated | Feb 1st, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134129919 | NPPES |
| Indiana | MEDICAID | 200413370A |
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