| Doctor Name: | MRS. KERRY LYNN EBUENG |
| NPI Number: | 1124334156 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PNP |
| License Number: | 20126 |
| Business Practice Address: | Building H100 Santa Margarita Road Naval Hospital Camp Pendleton Camp Pendleton, CA - 920555191 |
| Business Phone Number: | 7607258391 |
| Business Fax Number: | |
| Mailing Address: | Box 555191, Naval Hospital Camp Pendleton CAMP PENDLETON |
| State: | CA |
| Postal Code: | 920555191 |
| Phone Number: | 7607258391 |
| Fax Number: | |
| NPI Enumeration Date: | 08/27/2010 |
| NPI Last Update Date: | 08/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 20126 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |