Individual provider · Type 1 NPI
Jack Thomas Egnatz
Student in an Organized Health Care Education/Training Program · Bloomington, IN
NPI number
1619786704
Active
Practice location
281 W 11th St
Bloomington, IN 47404-3718
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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About NPI 1619786704
Jack Thomas Egnatz's National Provider Identifier is 1619786704, issued on Jan 2, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Bloomington, IN. The record was last updated on Jan 2, 2025.