Jessica Anne Eberly, ATC
Individual provider Active NPI Athletic Trainer · Milford, DE
NPI 1184744484 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1184744484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- J3-0000271 (DE)
- Practice address
- 329 Mullet Run
Milford, DE 19963-5373 - Phone
- (302) 424-1810
- Fax
- (302) 424-3092
- NPI assigned
- Mar 30, 2007
- 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 |
|---|---|---|---|
| J3-0000271 | DE | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | J3-0000271 | DE | Yes |
Addresses
Primary practice location
329 Mullet Run
Milford, DE 19963-5373
Mailing address
329 Mullet Run
Milford, DE 19963-5373
Phone (302) 424-1810
Other providers in Milford, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.