Engholm, Jason

Engholm, Jason is an sole proprietor health care provider with primary practice located at 650 Joel Dr , Fort Campbell KY 42223-5318. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Emergency, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Engholm, Jason can be contacted via phone (270) 798-8400.

Contact Information

Primary practice address
650 Joel Dr Fort Campbell KY 42223-5318
Phone: (270) 798-8400
Fax: (270) 798-8224
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Emergency 163WE0003X 168920 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 24887 Tennessee

Profile Details

NPI number 1528540812
LBN Legal business name Engholm, Jason
Credentials FNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 3rd, 2018
Last updated Apr 3rd, 2024 - about last year

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 1528540812 NPPES
Tennessee Other 168920 RN LISCENSE
Tennessee Other 24887 RN LISCENSE

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