Johanboeke, Cory Michael

Johanboeke, Cory Michael is an sole proprietor health care provider with primary practice located at 913 N Dixie Ave , Elizabethtown KY 42701-2503. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Johanboeke, Cory Michael can be contacted via phone (270) 737-1212.

Contact Information

Primary practice address
913 N Dixie Ave Elizabethtown KY 42701-2503
Phone: (270) 737-1212
Fax: (270) 706-1141
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1992936348
LBN Legal business name Johanboeke, Cory Michael
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 3rd, 2009
Last updated Sep 20th, 2009 - 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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