Individual
JEREMY BOCKELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
8033 DIXIE HWY, LOUISVILLE, KY 40258-1344
(502) 937-3155
(502) 935-0743
Mailing address
PO BOX 950202, LOUISVILLE, KY 40295-0202
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3008922
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000893307
ANTHEM-NMA
KY
01
—
165891
SIHO-NMA
KY
01
—
50076921
PASSPORT-NMA
KY
05
—
7100330320
—
KY
Enumeration date
09/11/2014
Last updated
04/15/2015
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