Jessie, Angela M

Jessie, Angela M is an sole proprietor health care provider with primary practice located at 109 Sartin Dr , Edmonton KY 42129-8170. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Jessie, Angela M can be contacted via phone (270) 432-2444.

Contact Information

Primary practice address
109 Sartin Dr Edmonton KY 42129-8170
Phone: (270) 432-2444
Fax: (270) 432-2445
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 3003026 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3003026 Kentucky

Profile Details

NPI number 1720050818
LBN Legal business name Jessie, Angela M
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 3rd, 2006
Last updated Jun 20th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720050818 NPPES
Kentucky Other 11386204 CAQH
Kentucky MEDICAID 78003944 CAQH

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