Healthcare Provider Details

I. General information

NPI: 1255692232
Provider Name (Legal Business Name): JAMIE BISEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 E PARRISH AVE SUITE 201B
OWENSBORO KY
42303-1449
US

IV. Provider business mailing address

2851 NEW HARTFORD RD STE A
OWENSBORO KY
42303-1320
US

V. Phone/Fax

Practice location:
  • Phone: 270-926-3700
  • Fax: 270-926-2114
Mailing address:
  • Phone: 270-240-2305
  • Fax: 270-240-2252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA1845
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: