| Jacob Floyd Keultjes, MSN, FNP-C | |
|
500 Arcade Ave Ste 320, Elkhart, IN 46514-2477 | |
| (574) 523-7900 | |
| (574) 523-7909 |
| Full Name | Jacob Floyd Keultjes |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Location | 500 Arcade Ave Ste 320, Elkhart, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336830454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 28215465A (Indiana) | Primary |
| Entity Name | Beacon Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033161617 PECOS PAC ID: 1254243306 Enrollment ID: O20031105000657 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Floyd Keultjes, MSN, FNP-C 3245 Health Dr Ste 100, Granger, IN 46530-1380 Ph: (574) 647-2129 | Jacob Floyd Keultjes, MSN, FNP-C 500 Arcade Ave Ste 320, Elkhart, IN 46514-2477 Ph: (574) 523-7900 |
Elizabeth W Maina, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052 | |
Ms. Cecilia Mumbi Maina, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052 | |
Mr. Kenneth Francis Raderstorf Iii, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3301 County Road 6 E, Elkhart, IN 46514 Phone: 574-266-5342 Fax: 574-266-5847 | |
Rosemary J Eash, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1627 E Bristol St, Elkhart, IN 46514 Phone: 574-262-0313 Fax: 574-262-8163 | |
Lorraine Doris Swartzentruber, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052 | |
Ashley Marie Brunt, NURSE PRA Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 600 East Blvd, Elkhart, IN 46514 Phone: 574-524-7102 Fax: 574-389-4859 | |
Mrs. Catherine E Dos Santos, MSN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3421 S Main St, Elkhart, IN 46517 Phone: 574-295-7178 Fax: 574-295-8822 |