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General NPI Number Information
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NPI Number | 1699278309
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Entity Type | Individual
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Provider Name | WILLIAM CURTIS EARNEST V FNP-C
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Gender | Male
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Dates
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Enumeration Date | 03/09/2018
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Last Update Date | 03/09/2018
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Provider Practice Location Address
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Address Line | 410 N MAIN ST
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City | PRINCETON
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State | IN
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Zip | 47670-1561
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Country | US
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Telephone | 812-386-7522
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Fax |
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Provider Business Mailing Address
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Address Line | 801 W ELM ST APT G
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City | HAUBSTADT
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State | IN
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Zip | 47639-8104
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Country | US
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Telephone | 601-503-5938
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71007845A
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License Number State | IN
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