Individual
JENNIFER E VICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 ROSE STREET, 6TH FLR, LEXINGTON, KY 40536
(859) 323-3385
(859) 323-3389
Mailing address
645 CROOKSVILLE RD, RICHMOND, KY 40475-9561
(859) 200-0207
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA872
KY
363AM0700X
Medical Physician Assistant
PA872
KY
363AS0400X
Surgical Physician Assistant
PA872
KY
Other
Enumeration date
06/17/2006
Last updated
01/21/2021
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