Evernham, Jenelle K
Evernham, Jenelle K is an individual health care provider with primary practice located at 2211 Mayfair Dr Ste 101 , Owensboro KY 42301-4569. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Evernham, Jenelle K can be contacted via phone (270) 688-1352.Contact Information
Primary practice address
2211 Mayfair Dr Ste 101
Owensboro KY 42301-4569
Phone: (270) 688-1352
Fax: (270) 683-4313
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 10001008A | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA1009 | Kentucky |
Profile Details
| NPI number | 1932375391 |
|---|---|
| LBN Legal business name | Evernham, Jenelle K |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 6th, 2008 |
| Last updated | Apr 11th, 2018 - about 6 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 | 1932375391 | NPPES |
| Kentucky | MEDICAID | 7100100710 | |
| Kentucky | MEDICAID | 300004679 |
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