Healthcare Provider Details

I. General information

NPI: 1518215326
Provider Name (Legal Business Name): JOCELYN ELHALAWANY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOCELYN SALEH

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 02/28/2022
Certification Date: 02/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 LONDON MOUNTAIN VIEW DR
LONDON KY
40741-6601
US

IV. Provider business mailing address

PO BOX 936
LONDON KY
40743-0936
US

V. Phone/Fax

Practice location:
  • Phone: 606-864-0770
  • Fax: 606-864-1461
Mailing address:
  • Phone: 606-864-0770
  • Fax: 606-330-7825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number3007593
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3007593
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: