MRS. JACQUELINE ANN EVELAND N.P. - NPI 1780815100 - Nurse Practitioner in Plymouth, IN

Q: What is Jacqueline Eveland's NPI number?

The NPI number for Jacqueline Eveland is 1780815100. It was assigned to this individual provider in the NPPES registry on August 3, 2009.

Q: What is Jacqueline Eveland's specialty?

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

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About Mrs. Jacqueline Ann Eveland N.p. NPPES

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

MRS. JACQUELINE ANN EVELAND N.P. (NPI 1780815100) is an individual family provider in Plymouth, Indiana, licensed in Indiana (28130507A) and active in the NPI registry since August 2009.

NPPES Registry Identity

NPI1780815100

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. JACQUELINE ANN EVELANDCredential: N.P.

Location Address209 E JEFFERSON STPlymouth, IN 46563-1861

Mailing AddressPo Box 6309South Bend, IN 46660-6309 · (574) 335-8700 · Fax (574) 335-0760

Phone(574) 941-3111

Fax(574) 335-0745

Sole ProprietorNo

Enumeration DateAugust 3, 2009

Last NPPES UpdateMay 7, 2015

✔ NPI 1780815100 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 IN · 28130507A

209 E JEFFERSON ST, Plymouth, IN 46563

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Other Identifiers 3

Other000000660693IN · Bcbs

Medicare PINM400020543IN

Medicare PINP01207571IN

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. CRYSTAL MARIE HORNER N.P.

Nurse Practitioner (Family)