Individual
MRS. JENNIFER TILLEY FICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4600 SHELBYVILLE RD STE 220, LOUISVILLE, KY 40207-3398
(502) 897-7546
Mailing address
3106 DANBURY CT, LOUISVILLE, KY 40242-2909
(270) 519-0847
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3011510
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3011510
AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD
KY
Enumeration date
06/25/2018
Last updated
06/25/2018
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