Mort, Jared Andrew

Mort, Jared Andrew is an individual health care provider with primary practice located at 2792 Rhett Dr , Beavercreek OH 45434-6259. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as his primary health care specialty. Mort, Jared Andrew can be contacted via phone (210) 488-8143.

Contact Information

Primary practice address
2792 Rhett Dr Beavercreek OH 45434-6259
Phone: (210) 488-8143
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 364SG0600X 11004509 Florida

Profile Details

NPI number 1538701933
LBN Legal business name Mort, Jared Andrew
Credentials APRN, CNS
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2019
Last updated Oct 17th, 2019 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538701933 NPPES
Florida Other 11004509 FLORIDA BOARD OF NURSING APRN LICENSE AS A CLINICAL NURSE SPECIALIST

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