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NPI Code Detail

MEDICARE: JEKEIJRA EVERSON

MEDICARE: JEKEIJRA EVERSON
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
1363AS0400XSurgical Physician Assistant
2363A00000XPhysician AssistantC5-0012229DE

General Provider Information

NPI Number : 1902750094
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEKEIJRA EVERSON
Provider Business Mailing Address
First Line : 1515 SAVANNAH RD FL 2
Second Line :
City : LEWES
State : DE
Zip : 19958-1675
Country : US
Telephone Number : 302-645-3499
Fax Number : 302-644-4830
Provider Business Practice Location Address
First Line : 424 SAVANNAH RD
Second Line :
City : LEWES
State : DE
Zip : 19958-1462
Country : US
Telephone Number : 302-645-2437
Fax Number : 833-629-0820
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2026
Last Update Date : 06/02/2026

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