Individual
KENNETH A EBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1500 S LAKE PARK AVE, HOBART, IN 46342-6638
(219) 947-6695
(219) 947-6092
Mailing address
1500 S LAKE PARK AVE, HOBART, IN 46342-6638
(219) 947-6695
(219) 947-6092
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28128216A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200097770
—
IN
Enumeration date
05/12/2006
Last updated
08/04/2015
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