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General NPI Number Information
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NPI Number | 1801479985
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Entity Type | Individual
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Provider Name | JESSICA PRICE
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Gender | Female
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 5 LINVILLE DR STE 100
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City | PARIS
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State | KY
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Zip | 40361-2165
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Country | US
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Telephone | 859-987-3388
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Fax |
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Provider Business Mailing Address
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Address Line | 126 GREYSTONE CT
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City | PARIS
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State | KY
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Zip | 40361-6000
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Country | US
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Telephone | 859-707-2324
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3015151
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License Number State | KY
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