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General NPI Number Information
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NPI Number | 1457982969
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Entity Type | Individual
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Provider Name | JESSICA BRIANNE MILLAY FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/03/2020
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 1221 N MAIN ST
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City | BEAVER DAM
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State | KY
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Zip | 42320-8955
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Country | US
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Telephone | 270-775-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 N MAIN ST
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City | BEAVER DAM
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State | KY
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Zip | 42320-8955
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Country | US
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Telephone | 270-775-6060
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Fax | 270-775-6010
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3014252
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License Number State | KY
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