Kenneth Allan Ebersole in Lake Charles - Family
Kenneth Allan Ebersole - NPI 1699746487
Kenneth Allan Ebersole is a Family in Lake Charles, Louisiana. Kenneth Allan Ebersole practices all healthcare services and medical treatments related to Family. The NPI Number for Kenneth Allan Ebersole is 1699746487. The last update date is 2017-03-20.
Kenneth Allan Ebersole's current location address is 501 Doctor Michael Debakey Dr, Lake Charles, Louisiana. You can contact this provider via phone number 3373128258 and fax number 3373126708. The mailing address for Kenneth Allan Ebersole is 501 Doctor Michael Debakey Dr, Lake Charles, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Allan Ebersole |
|---|---|
| Address | 501 Doctor Michael Debakey Dr, Lake Charles, Louisiana |
| Phone Number | 3373128258 |
| Fax Number | 3373126708 |
| Sole Proprietor | N |
| Credentials | APRN,FNP |
NPI Number Detail
| NPI Number | 1699746487 |
|---|---|
| Provider Enumeration Date | 2006-01-30 |
| Last Updated Date | 2017-03-20 |
Provider Mailing Address Detail
| Address | 501 Doctor Michael Debakey Dr |
|---|---|
| City | Lake Charles |
| State | Louisiana (LA) |
| Post Code | 706015724 |
| Phone Number | 3373128258 |
| Fax Number | 3373126708 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | AP03160 |
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Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1558761 | LA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Kenneth Allan Ebersole?
The Kenneth Allan Ebersole has been issued the NPI (National Provider Identifier) 1699746487 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Kenneth Allan Ebersole?
The Kenneth Allan Ebersole is situated at 501 Doctor Michael Debakey Dr, in the city of Lake Charles, state of LA, with the zip code 706015724.
What is the Kenneth Allan Ebersole's area of specialization and corresponding taxonomy classification?
The Kenneth Allan Ebersole's specialty field is Family, and it falls under the taxonomy code 363Lf0000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1699746487 to Kenneth Allan Ebersole?
The Kenneth Allan Ebersole received its 1699746487 assignment from the Centers for Medicare & Medicaid Services on 2006-01-30.
As of what date were the details related to Kenneth Allan Ebersole most recently updated or revised?
The information pertaining to Kenneth Allan Ebersole, including its address, specialty, and other relevant details, was last updated or revised on 2017-03-20.