Provider Demographics
NPI:1689342297
Name:CARTHEL, JASON LYN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:LYN
Last Name:CARTHEL
Suffix:
Gender:M
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 1:7421 SW 119TH ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:NE
Mailing Address - Zip Code:68339-3258
Mailing Address - Country:US
Mailing Address - Phone:402-326-4834
Mailing Address - Fax:
Practice Address - Street 1:7421 SW 119TH ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:NE
Practice Address - Zip Code:68339-3258
Practice Address - Country:US
Practice Address - Phone:402-326-4834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2517363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical