Provider Demographics
NPI:1972345494
Name:EVERETT, ANN (PA-C)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:EVERETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 HETTER ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-9017
Mailing Address - Country:US
Mailing Address - Phone:614-915-8801
Mailing Address - Fax:
Practice Address - Street 1:5005 ARLINGTON CENTRE BLVD
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43220-2912
Practice Address - Country:US
Practice Address - Phone:614-246-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant