Provider Demographics
NPI:1326855875
Name:EKBLOM, JANEL MARIE (FNP)
Entity type:Individual
Prefix:
First Name:JANEL
Middle Name:MARIE
Last Name:EKBLOM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:JANEL
Other - Middle Name:MARIE
Other - Last Name:SCHAEFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 SUMAC CT
Mailing Address - Street 2:
Mailing Address - City:N TOPSAIL BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28460-5503
Mailing Address - Country:US
Mailing Address - Phone:813-523-2332
Mailing Address - Fax:
Practice Address - Street 1:317 WESTERN BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6379
Practice Address - Country:US
Practice Address - Phone:910-577-2471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5021255363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily