Jennette, Christa Dawn

Jennette, Christa Dawn is an sole proprietor health care provider with primary practice located at 1113 Keiffer Dr , Olney IL 62450. She recently has only one registered license in Transportation Services / Private Vehicle, which is considered as her primary health care specialty. Jennette, Christa Dawn can be contacted via phone (618) 392-4106.

Contact Information

Primary practice address
1113 Keiffer Dr Olney IL 62450
Phone: (618) 392-4106
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Transportation Services / Private Vehicle 347C00000X

Profile Details

NPI number 1942476908
LBN Legal business name Jennette, Christa Dawn
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 30th, 2008
Last updated Apr 30th, 2008 - about 16 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 1942476908 NPPES
Illinois MEDICAID 189837230

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