Healthcare Provider Details

I. General information

NPI: 1770902967
Provider Name (Legal Business Name): JEANNE GRIPSHOVER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8731 BANKERS ST
FLORENCE KY
41042-4240
US

IV. Provider business mailing address

8731 BANKERS ST UNIT A
FLORENCE KY
41042-4240
US

V. Phone/Fax

Practice location:
  • Phone: 859-282-8840
  • Fax: 859-282-8830
Mailing address:
  • Phone: 859-282-8840
  • Fax: 859-282-8830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3012550
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: