Healthcare Provider Details

I. General information

NPI: 1154155141
Provider Name (Legal Business Name): JAMIE R HOEHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2024
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E MARKET ST # A
LOUISVILLE KY
40202-1218
US

IV. Provider business mailing address

204 E MARKET ST # A
LOUISVILLE KY
40202-1218
US

V. Phone/Fax

Practice location:
  • Phone: 270-599-8463
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: