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General NPI Number Information
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NPI Number | 1255827788
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Entity Type | Individual
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Provider Name | JESSICA MINNICK AUD
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Gender | Female
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Dates
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Enumeration Date | 07/09/2018
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 740 S LIMESTONE ST STE C300
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City | LEXINGTON
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State | KY
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Zip | 40536-1688
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Country | US
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Telephone | 859-257-3390
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Fax | 859-323-5483
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Provider Business Mailing Address
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Address Line | 157 CORLEY MILL RD
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City | LEXINGTON
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State | SC
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Zip | 29072-7600
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Country | US
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Telephone |
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Fax |
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 260484
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License Number State | KY
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