Provider Demographics
NPI:1467400945
Name:DEUTSCH, JAUHNA K (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JAUHNA
Middle Name:K
Last Name:DEUTSCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 GATEWAY BLVD
Mailing Address - Street 2:SUITE 2120
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8925
Mailing Address - Country:US
Mailing Address - Phone:812-842-0907
Mailing Address - Fax:812-464-0565
Practice Address - Street 1:4015 GATEWAY BLVD
Practice Address - Street 2:SUITE 2120
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8925
Practice Address - Country:US
Practice Address - Phone:812-842-0907
Practice Address - Fax:812-464-0555
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99014177A363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000341013OtherANTHEM
691190OtherHEALTHLINK
062860OtherSIHO
KY95005419Medicaid
062860OtherSIHO
KY95005419Medicaid
000000341013OtherANTHEM
IN532500CCCMedicare ID - Type UnspecifiedIN MCR