Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | 3010344 | KY |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 3010344 | KY |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 3010344 | KY |
NPI | 1447793872 |
---|---|
Provider Name | Jessica Michelle Marshal |
First Address | Lexington, KY 40503-1431 |
Second Address | Lexington, KY 40503-1431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2016 |
Last Update Date | 27/06/2019 |