Individual
JANA RENEE GANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
555 W SUN ST, MOREHEAD, KY 40351-1563
(606) 207-2931
(606) 783-0964
Mailing address
555 W SUN ST, MOREHEAD, KY 40351-1563
(606) 207-2931
(606) 783-0964
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
3002241
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78001237
—
KY
Enumeration date
06/08/2006
Last updated
08/07/2012
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