Individual
JESSICA LYNNELLE COON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
343 WALLER AVE STE 201, LEXINGTON, KY 40504-2918
(859) 271-9448
Mailing address
343 WALLER AVE STE 201, LEXINGTON, KY 40504-2918
(859) 271-9448
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
01/06/2014
Last updated
06/21/2016
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