Ebersole, Kenneth Allan

Ebersole, Kenneth Allan is an individual health care provider with primary practice located at 277 N Highway 171 Suite 10, Lake Charles LA 70611-5374. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Ebersole, Kenneth Allan can be contacted via phone (337) 217-7762.

Contact Information

Primary practice address
277 N Highway 171 Suite 10 Lake Charles LA 70611-5374
Phone: (337) 217-7762
Fax: (337) 855-5310
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP03160 Louisiana

Profile Details

NPI number 1699746487
LBN Legal business name Ebersole, Kenneth Allan
Credentials APRN,FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Mar 20th, 2017 - about 9 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 1699746487 NPPES
Louisiana MEDICAID 1558761

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