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Individual

ETHAN JEVON MERKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGACNP-BC

Contact information

Practice address
721 W 13TH ST STE 221, JASPER, IN 47546-1817
(812) 996-0564
Mailing address
PO BOX 1028, JASPER, IN 47547-1028
(812) 996-8478

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71008754A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71008754A
IN

Other

Enumeration date
01/16/2019
Last updated
04/09/2026
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