Individual
LORI JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1024 N MAIN ST, NICHOLASVILLE, KY 40356-2311
(859) 241-2148
(859) 241-2934
Mailing address
2700 STANLEY GAULT PKWY, SUITE 129, LOUISVILLE, KY 40223-5132
(502) 253-4914
(502) 489-5751
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1083901
KY
Other
Enumeration date
03/14/2011
Last updated
12/09/2020
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