Individual
JENNIE KAYE BOURNE
Active
Individual
JENNIE KAYE BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, ARNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3005174
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
363LA2200X
TAXONOMY
KY
05
—
7100016740
—
KY
Enumeration date
09/19/2005
Last updated
08/03/2023
Update your record
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