Healthcare Provider Details

I. General information

NPI: 1568292498
Provider Name (Legal Business Name): JASON C HARPER APRN-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2429 W PARRISH AVE
OWENSBORO KY
42301-2661
US

IV. Provider business mailing address

2429 W PARRISH AVE
OWENSBORO KY
42301-2661
US

V. Phone/Fax

Practice location:
  • Phone: 270-929-0014
  • Fax:
Mailing address:
  • Phone: 270-929-0014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4025569
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: