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Individual

JOHN ERIC ROE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1011 OLD HIGHWAY 60, HARDINSBURG, KY 40143
(270) 756-7000
Mailing address
1347 NEVINS STATION RD, LAWRENCEBURG, KY 40342-9759

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
700663
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3010062
APRN LICENSE
KY
01
700663
CRNA CERTIFICATION
KY
Enumeration date
01/18/2016
Last updated
11/25/2019
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