Healthcare Provider Details

I. General information

NPI: 1760628507
Provider Name (Legal Business Name): JESSICA FOX ABNEY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2008
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W MARKET ST STE 2
LOUISVILLE KY
40202-1332
US

IV. Provider business mailing address

PO BOX 950248
LOUISVILLE KY
40295-0248
US

V. Phone/Fax

Practice location:
  • Phone: 502-587-8000
  • Fax: 502-583-8001
Mailing address:
  • Phone: 502-489-5730
  • Fax: 502-489-5733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1093817
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5857P
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1093817
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: