Provider Demographics
NPI:1649763129
Name:EHLERS JASCHEN, BRYNN EMILY (DO)
Entity Type:Individual
Prefix:DR
First Name:BRYNN
Middle Name:EMILY
Last Name:EHLERS JASCHEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:BRYNN
Other - Middle Name:EMILY
Other - Last Name:EHLERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1120 15TH ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1650 COWLES ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-5907
Practice Address - Country:US
Practice Address - Phone:907-458-5178
Practice Address - Fax:907-458-5180
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA010038208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics