Individual
ELIZABETH JEAN LOAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101-2843
(606) 408-4000
Mailing address
PO BOX 1595, ASHLAND, KY 41105-1595
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
198028
KY
363LF0000X
Family Nurse Practitioner
Primary
3014609
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1091208
RN
KY
Enumeration date
07/13/2020
Last updated
12/14/2020
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