Jennifer Krasovic Eubank, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA030672 Issued in DC

Practice address

US Dept Ofstate
M/Med/Qi, Sa-1
Washington, DC 20522-0102

Phone

(937) 776-9026

NPI assigned

Oct 23, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Galaria Plastic Surgery & Dermatology

  • Multi-Specialty Clinic/Center
  • Chantilly, VA
  • NPI 1881052165
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1669555652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "US DEPT OFSTATE",
            "address_2": "M/MED/QI, SA-1",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "205220102",
            "telephone_number": "937-776-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US DEPT OFSTATE",
            "address_2": "M/MED/QI, SA-1",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "205220102",
            "telephone_number": "937-776-9026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANK",
        "first_name": "JENNIFER",
        "middle_name": "KRASOVIC",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA030672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Etta'S Embrace LLC
• Ilynne Etuge Ebane Tong
• Irene Epolle Etuge
• Margaret Mboe Etukeni
• Ifeanyi J Etumnu
• Dorese Eubanks
• Karon Eubanks
• Ronesha Maryam Eubanks
• Eugene C. Gadaire, D.D.S.
• Eugene Miknowski M.D., P.C.

• Physician Assistant in Washington, DC
• Providers in Washington, DC by specialty
• Physician Assistant in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.