Individual
JACQUELINE LEIGHT REICHERT GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
334 FARMINGTON DR, LAKESIDE PARK, KY 41017-3195
(859) 446-6263
Mailing address
334 FARMINGTON DR, LAKESIDE PARK, KY 41017-3195
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
.023697
OH
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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