Eatherly, Jennifer
Eatherly, Jennifer is an sole proprietor health care provider with primary practice located at 875 S Collegiate Dr , Paris TX 75460-6305. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Eatherly, Jennifer can be contacted via phone (903) 785-8857.Contact Information
Primary practice address
875 S Collegiate Dr
Paris TX 75460-6305
Phone: (903) 785-8857
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP131104 | Texas |
Profile Details
| NPI number | 1154771228 |
|---|---|
| LBN Legal business name | Eatherly, Jennifer |
| Credentials | MSN, APRN, NP-C |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 20th, 2016 |
| Last updated | Jul 21st, 2022 - about 4 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 | 1154771228 | NPPES |
| Texas | MEDICAID | 360754101 | |
| Texas | Other | 200678330A |
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