Jetta L Almon, CST, CSFA
Individual provider Active NPI Surgical Assistant · Evansville, IN
NPI 1104073519 · NPPES record last updated May 3, 2019
Key facts
- NPI
- 1104073519
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Assistant 246ZC0007X
- License
- 95829 (IN)
- Practice address
- 1207 SE Riverside Dr
Evansville, IN 47713-1166 - Phone
- (812) 484-2689
- NPI assigned
- Aug 27, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95829 | IN | MD | Surgical Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 95829 | IN | Yes |
Addresses
Primary practice location
1207 SE Riverside Dr
Evansville, IN 47713-1166
Mailing address
1207 SE Riverside Dr
Evansville, IN 47713-1166
Phone (812) 484-2689
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000001069797 | Other | IN | ANTHEM BCBS |
Other providers in Evansville, IN
- Allison Marie Allgood
- Lynn S Alling
- Melinda Allred
- Allure Wellness and Health Center LLC
- Dana L Allyn
- James V Alsop
- Meagan Lynne Althoff
- Melissa Dawn Altman
- Patricia Altman
- Shaun M Altneu
All providers in Evansville, IN · Surgical Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.