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General NPI Number Information
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NPI Number | 1801228317
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Entity Type | Individual
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Provider Name | JENNIFER L VERTREES APRN
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Gender | Female
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Dates
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Enumeration Date | 08/07/2013
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 11969 S DIXIE HWY
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City | SONORA
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State | KY
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Zip | 42776-9739
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Country | US
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Telephone | 270-369-9706
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Fax |
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Provider Business Mailing Address
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Address Line | 11969 S DIXIE HWY
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City | SONORA
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State | KY
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Zip | 42776-9739
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Country | US
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Telephone | 270-369-9706
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Fax | 270-706-1914
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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 | 3008105
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License Number State | KY
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