Individual
MRS. ELIZABETH A. JERNAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN
Contact information
Practice address
315 W OLD KEY DR, PERU, IN 46970-9057
(765) 475-6963
Mailing address
315 W OLD KEY DR, PERU, IN 46970
(765) 475-6963
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003534
IN
390200000X
Student in an Organized Health Care Education/Training Program
28151141A
IN
Other
Enumeration date
01/10/2011
Last updated
04/01/2014
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