Healthcare Provider Details

I. General information

NPI: 1275520454
Provider Name (Legal Business Name): J & L HEALTHCARE CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2387 PROFESSIONAL HEIGHTS DR STE 180
LEXINGTON KY
40503-3013
US

IV. Provider business mailing address

2387 PROFESSIONAL HEIGHTS DR STE 180
LEXINGTON KY
40503-3013
US

V. Phone/Fax

Practice location:
  • Phone: 859-967-9486
  • Fax: 859-368-7780
Mailing address:
  • Phone: 859-967-9486
  • Fax: 859-368-7780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. LORI ANN WAGNER
Title or Position: MEMBER
Credential: APRN
Phone: 859-797-5558