Ebolum, Janis D

Ebolum, Janis D is an individual health care provider with primary practice located at 140 Dover St , Shelbyville TN 37160-2776. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Ebolum, Janis D can be contacted via phone (931) 684-3426.

Contact Information

Primary practice address
140 Dover St Shelbyville TN 37160-2776
Phone: (931) 684-3426
Fax: (931) 684-5860
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN0000005513 Tennessee

Profile Details

NPI number 1710985072
LBN Legal business name Ebolum, Janis D
Credentials APRN-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2005
Last updated Jul 14th, 2012 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710985072 NPPES
Tennessee MEDICAID 3897887
Tennessee Other 4057644

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