Eveland, Jacqueline Ann
Eveland, Jacqueline Ann is an individual health care provider with primary practice located at 209 E Jefferson St , Plymouth IN 46563-1861. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Eveland, Jacqueline Ann can be contacted via phone (574) 941-3111.Contact Information
Primary practice address
209 E Jefferson St
Plymouth IN 46563-1861
Phone: (574) 941-3111
Fax: (574) 335-0745
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 28130507A | Indiana |
Profile Details
| NPI number | 1780815100 |
|---|---|
| LBN Legal business name | Eveland, Jacqueline Ann |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2009 |
| Last updated | May 7th, 2015 - about 9 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 | 1780815100 | NPPES |
| Indiana | Other | 000000660693 | BCBS |
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