Individual
JACQUES NICHOLAS BURRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 757-2927
(859) 341-0203
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 344-5555
(859) 344-5552
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3016302
KY
363L00000X
Nurse Practitioner
71014904A
IN
363LA2100X
Acute Care Nurse Practitioner
3016302
KY
Other
Enumeration date
05/21/2021
Last updated
03/26/2024
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