Fegenbush, Carolyn R

Fegenbush, Carolyn R is an individual health care provider with primary practice located at 1802 E 10Th St , Jeffersonville IN 47130-6016. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Fegenbush, Carolyn R can be contacted via phone (812) 288-2488.

Contact Information

Primary practice address
1802 E 10Th St Jeffersonville IN 47130-6016
Phone: (812) 288-2488
Fax: (770) 573-9513
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 71001579A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71001579A Indiana

Profile Details

NPI number 1629009790
LBN Legal business name Fegenbush, Carolyn R
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Nov 8th, 2021 - about 5 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 1629009790 NPPES
Other 2823492000 PASSPORT ADVANTAGE
MEDICAID 200451720 PASSPORT ADVANTAGE
Other 50014111 PASSPORT ADVANTAGE
MEDICAID 78010824 PASSPORT ADVANTAGE
Other P00424435 PASSPORT ADVANTAGE

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