Koeller, Jennifer

Koeller, Jennifer is an sole proprietor health care provider with primary practice located at 700 Doctors Ct , Leesburg FL 34748-7314. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Koeller, Jennifer can be contacted via phone (352) 787-9838.

Contact Information

Primary practice address
700 Doctors Ct Leesburg FL 34748-7314
Phone: (352) 787-9838
Fax: (352) 787-8705
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9108194 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 25MP00337400 New Jersey

Profile Details

NPI number 1043625809
LBN Legal business name Koeller, Jennifer
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2014
Last updated Feb 13th, 2017 - about 7 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 1043625809 NPPES
Florida Other PA9108194 MEDICAL LICENSE

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