Individual
MRS. JESSICA RYAN HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2300 CHAMBER CENTER DR, LAKESIDE PARK, KY 41017
(859) 655-7040
(859) 331-2021
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3013821
KY
363LA2200X
Adult Health Nurse Practitioner
COA.14129-NP
OH
Other
Enumeration date
07/02/2013
Last updated
09/17/2019
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