Healthcare Provider Details

I. General information

NPI: 1154982262
Provider Name (Legal Business Name): JESSICA NICOLE BROWNING APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1698 OLD LEBANON RD STE 2A
CAMPBELLSVILLE KY
42718-3319
US

IV. Provider business mailing address

1698 OLD LEBANON RD
CAMPBELLSVILLE KY
42718-3319
US

V. Phone/Fax

Practice location:
  • Phone: 270-789-0359
  • Fax: 270-789-1756
Mailing address:
  • Phone: 270-789-0359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3013354
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: