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General NPI Number Information
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NPI Number | 1508245960
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Entity Type | Individual
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Provider Name | JODI LYNN CARNEY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/19/2015
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 1107 CROWN POINTE DR STE 107
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-7280
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Country | US
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Telephone | 270-506-3300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21890
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City | BELFAST
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State | ME
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Zip | 04915-4115
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Country | US
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Telephone | 502-907-0356
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Fax | 502-919-9780
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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 | 3009322
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License Number State | KY
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