Individual
JESSICA BERRES HOULIHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2400 GREATSTONE PT, LEXINGTON, KY 40504-3274
(859) 323-6211
(859) 323-1315
Mailing address
1804 BIMINI RD, LEXINGTON, KY 40502-2840
(859) 396-8125
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1966
KY
363AM0700X
Medical Physician Assistant
PA1966
KY
363AS0400X
Surgical Physician Assistant
PA1966
KY
Other
Enumeration date
09/29/2014
Last updated
11/13/2024
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