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General NPI Number Information
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NPI Number | 1093028037
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Entity Type | Individual
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Provider Name | JENNIFER R O'BRYAN CDE, RN
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Gender | Female
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Dates
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Enumeration Date | 07/20/2010
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 2195 HARRODSBURG RD STE 125
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City | LEXINGTON
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State | KY
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Zip | 40504-3543
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Country | US
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Telephone | 859-323-2232
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Fax | 859-257-1078
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Provider Business Mailing Address
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Address Line | PO BOX 950202
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City | LOUISVILLE
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State | KY
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Zip | 40295-0202
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Country | US
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Telephone | 502-272-5100
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Fax | 502-272-5116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 129923
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 1087693
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License Number State | KY
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