Individual
JESSICA L WITHROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1900 BLUEGRASS AVE STE 103, LOUISVILLE, KY 40215-1144
(502) 367-4500
(502) 368-8139
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 367-4500
(502) 368-8139
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3013205
KY
Other
Enumeration date
10/25/2019
Last updated
05/01/2020
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