Individual
JESSICA MUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1239 WOODLAND DR STE 108, ELIZABETHTOWN, KY 42701
(270) 765-4535
(270) 763-1901
Mailing address
1239 WOODLAND DR STE 108, ELIZABETHTOWN, KY 42701-2770
(270) 765-4535
(270) 763-1901
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3008857
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3008857
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3008857
LISCENSE
KY
Enumeration date
02/13/2015
Last updated
06/21/2018
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