Jennifer Elaine Eubanks, BSN

Individual provider Active NPI Administrator Registered Nurse · Cedartown, GA

NPI 1356970503 · NPPES record last updated Apr 8, 2020

Key facts

NPI
1356970503
Entity type
Individual (NPI type 1)
Primary specialty
Administrator Registered Nurse 163WA2000X
License
RN117871 (GA)
Practice address
740 Fletcher St
Cedartown, GA 30125-3249
Phone
(770) 749-5336
Fax
(770) 748-5022
NPI assigned
Apr 8, 2020
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
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN117871GAMDAdministrator Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X RN117871 GA Yes

Addresses

Primary practice location

740 Fletcher St
Cedartown, GA 30125-3249

Mailing address

740 Fletcher St
Cedartown, GA 30125-3249
Phone (770) 749-5336

Other providers in Cedartown, GA

All providers in Cedartown, GA · Administrator Registered Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.