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General NPI Number Information
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NPI Number | 1730004425
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Entity Type | Organization
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Legal Business Name | JUNEWOOD MED SPA & WELLNESS INC
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 1235 NEBO RD
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City | MADISONVILLE
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State | KY
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Zip | 42431-8827
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Country | US
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Telephone | 270-871-4070
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Fax |
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Provider Business Mailing Address
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Address Line | 4440 STATE ROUTE 1835
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City | SLAUGHTERS
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State | KY
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Zip | 42456-9286
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Country | US
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Telephone | 270-871-4070
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REGINA J SISK
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Credential | DNP, APRN
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Telephone | 270-871-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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