Individual
DR. JENNIFER LYNN EBERLIN-NAGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2317 FRANKLIN ST, MICHIGAN CITY, IN 46360
(219) 874-3211
(219) 879-1666
Mailing address
PO BOX 549, WABASH, IN 46992-0549
(260) 569-9550
(260) 569-0760
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003339A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200853890
—
IN
05
—
248270R
—
IN
Enumeration date
09/15/2006
Last updated
08/15/2018
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