Individual
JEANIE NICOLE DOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
627 W FAIRVIEW AVE, EDDYVILLE, KY 42038-7386
(270) 388-5454
(270) 388-5452
Mailing address
1901 CAMPUS PL, LOUISVILLE, KY 40299-2308
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3009544
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3009544
APRN LICENSE
KY
Enumeration date
07/28/2015
Last updated
08/26/2024
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