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General NPI Number Information
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NPI Number | 1942755640
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Entity Type | Individual
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Provider Name | JENNIFER DAWN SALLEE ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 10/25/2017
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Provider Practice Location Address
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Address Line | 913 N DIXIE AVE
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2503
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Country | US
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Telephone | 877-783-6287
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Fax |
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Provider Business Mailing Address
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Address Line | 1754 CENTER POINT RD
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City | WHITE MILLS
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State | KY
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Zip | 42788-9711
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Country | US
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Telephone | 850-461-2292
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3010908
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License Number State | KY
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