Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 46380 | KY |
N | 111NI0900X | Internist | 46380 | KY |
Y | 207RA0401X | Internist - Addiction Medicine | 46380 | KY |
NPI | 1518111731 |
---|---|
Provider Name | Dr. Anastasia A. S. Jandes |
First Address | Lexington, KY 40555-4448 |
Second Address | Lexington, KY 40505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2008 |
Last Update Date | 18/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100375100 | (05) | KY |