Healthcare Provider Details

I. General information

NPI: 1891937926
Provider Name (Legal Business Name): JENNIFER A. EBERT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1262 E BROAD AVE
ROCKINGHAM NC
28379-4902
US

IV. Provider business mailing address

1262 E BROAD AVE
ROCKINGHAM NC
28379-4902
US

V. Phone/Fax

Practice location:
  • Phone: 910-817-9200
  • Fax:
Mailing address:
  • Phone: 919-532-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3857
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5025198
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: