Individual
JENELLE C HALLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
12450 LA GRANGE RD, LOUISVILLE, KY 40245-1901
(502) 638-4783
Mailing address
PO BOX 932958, CLEVELAND, OH 44193-0028
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1140783
KY
363LF0000X
Family Nurse Practitioner
Primary
4034783
KY
Other
Enumeration date
08/21/2023
Last updated
07/03/2025
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