=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902319254
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMI RAY BLOCK NNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2017
-----------------------------------------------------
Last Update Date | 05/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1201 PLEASANT VALLEY RD FL 3
-----------------------------------------------------
City | OWENSBORO
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42303-9811
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-417-5390
-----------------------------------------------------
Fax | 270-417-0165
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 23229
-----------------------------------------------------
City | OWENSBORO
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42304-3229
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-688-1330
-----------------------------------------------------
Fax | 270-688-1338
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.024375
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LN0000X
-----------------------------------------------------
Taxonomy Name | Neonatal Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.024375
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LN0005X
-----------------------------------------------------
Taxonomy Name | Critical Care Neonatal Nurse Practitioner
-----------------------------------------------------
License Number | 3011877
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 363LN0005X
-----------------------------------------------------
Taxonomy Name | Critical Care Neonatal Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.024375
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 363LN0000X
-----------------------------------------------------
Taxonomy Name | Neonatal Nurse Practitioner
-----------------------------------------------------
License Number | 3011877
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------