Provider Demographics
NPI:1841514957
Name:EBERHARTER, PATRICIA ANN (FNP-BC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:EBERHARTER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 JACKSBORO PIKE STE 1A
Mailing Address - Street 2:
Mailing Address - City:JACKSBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37757-2752
Mailing Address - Country:US
Mailing Address - Phone:423-907-8186
Mailing Address - Fax:423-907-8187
Practice Address - Street 1:2707 JACKSBORO PIKE STE 1A
Practice Address - Street 2:
Practice Address - City:JACKSBORO
Practice Address - State:TN
Practice Address - Zip Code:37757-2752
Practice Address - Country:US
Practice Address - Phone:423-907-8186
Practice Address - Fax:423-907-8187
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000014789363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily