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MR. KENNETH ALLAN EBERSOLE APRN,FNP
NPI 1699746487
Nurse Practitioner - Family in Lake Charles, LA

Active since January 30, 2006
277 N HIGHWAY 171, SUITE 10, LAKE CHARLES, LA 70611(337) 217-7762(337) 855-5310 Get Directions Write a Review

NPPES record last updated: March 20, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Kenneth Allan Ebersole Aprn,fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KENNETH ALLAN EBERSOLE APRN,FNP (NPI 1699746487) is an individual family provider in Lake Charles, Louisiana, licensed in Louisiana (AP03160) and active in the NPI registry since January 2006.

NPPES Registry Identity

NPI1699746487
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. KENNETH ALLAN EBERSOLECredential: APRN,FNP
Location Address277 N HIGHWAY 171, SUITE 10Lake Charles, LA 70611-5374
Mailing Address501 Doctor Michael Debakey DrLake Charles, LA 70601-5724 · (337) 312-8258 · Fax (337) 312-6708
Phone(337) 217-7762
Fax(337) 855-5310
Sole ProprietorNo
Enumeration DateJanuary 30, 2006
Last NPPES UpdateMarch 20, 2017
✔ NPI 1699746487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in LA · AP03160
277 N HIGHWAY 171, Lake Charles, LA 70611
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Other Identifiers 4

Medicare UPINS54701LA
Medicare PINP01076979LA
Medicaid1558761LA
Medicare PIN5X5147460LA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Ebersole's NPI number?

The NPI number for Kenneth Ebersole is 1699746487. It was assigned to this individual provider in the NPPES registry on January 30, 2006.

Where is Kenneth Ebersole located?

Kenneth Ebersole practices at 277 N Highway 171 Suite 10, Lake Charles, LA 70611. The listed phone number is (337) 217-7762.

What is Kenneth Ebersole's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Kenneth Ebersole was last updated on March 20, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.