Jeanie Nicole Doom
Nurse Practitioner - Family Medicine
1860 Jh Obryan Ave
Grand Rivers
, Kentucky 42045-9049
Jeanie Nicole Doom
Nurse Practitioner - Family Medicine
1860 Jh Obryan Ave
Grand Rivers
, Kentucky 42045-9049
(270) 362-9757
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About
Features
Specialties
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Jeanie Nicole Doom
- 1860 Jh Obryan Ave
- Grand Rivers, KY
- Zip : 42045-9049
- Fax : (270) 362-9757
- Phone : (270) 362-8246
Second Address
- Jeanie Nicole Doom
- 1860 Jh Obryan Ave
- Grand Rivers, KY
- Zip : 42045-9049
- Fax : (270) 362-9757
- Phone : (270) 362-8246
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3009544 | KY |
National Provider Identifier
| NPI | 1003291360 |
|---|---|
| Provider Name | Jeanie Nicole Doom |
| First Address | Grand Rivers, KY 42045-9049 |
| Second Address | Grand Rivers, KY 42045-9049 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/07/2015 |
| Last Update Date | 28/07/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 3009544 | APRN LICENSE (01) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.