Healthcare Provider Details

I. General information

NPI: 1134628126
Provider Name (Legal Business Name): JESSICA LYNN FRANEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 12/04/2020
Certification Date: 12/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PROVIDENCE WAY STE 200
NICHOLASVILLE KY
40356-6033
US

IV. Provider business mailing address

5200 COMMERCE CROSSINGS DR FL 3
LOUISVILLE KY
40229-2182
US

V. Phone/Fax

Practice location:
  • Phone: 859-230-5370
  • Fax: 859-260-5379
Mailing address:
  • Phone: 502-253-4977
  • Fax: 502-489-5751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA000
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: