Individual
EMILY JUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4915 NORTON HEALTHCARE BLVD STE 202, LOUISVILLE, KY 40241-2861
(502) 891-8300
(502) 394-6525
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5754
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2662
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100691640
—
KY
01
—
K342230
MEDICARE
KY
01
—
PA-2662
KY LICENSE
KY
Enumeration date
04/20/2020
Last updated
01/26/2021
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