MEDICARE: JASON C HARPER APRN-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	4025569	KY

General Provider Information

NPI Number	:	1568292498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON C HARPER APRN-BC

Provider Business Mailing Address
First Line	:	PO BOX 23229
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42304-3229
Country	:	US
Telephone Number	:	270-844-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	9117 BIRK CITY RD
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-9408
Country	:	US
Telephone Number	:	270-577-6904
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2024
Last Update Date	:	11/11/2024

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