Provider Demographics
NPI:1669619516
Name:EBERT, JENNIFER PEARL (FNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PEARL
Last Name:EBERT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-4201
Mailing Address - Country:US
Mailing Address - Phone:785-238-4711
Mailing Address - Fax:
Practice Address - Street 1:222 N 6TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-4956
Practice Address - Country:US
Practice Address - Phone:785-320-7134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO188976163W00000X
CO5953363LF0000X
KS75858363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse