Individual
JENNIFER LISTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
613 23RD ST, SUITE 230, ASHLAND, KY 41101-2878
(606) 324-4745
(606) 324-4941
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 324-4745
(606) 324-4941
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35.096232
OH
207RC0000X
Cardiovascular Disease Physician
Primary
43886
KY
207RC0000X
Cardiovascular Disease Physician
TP449
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3112081
—
OH
05
—
3810019206
—
WV
05
—
7100140590
—
KY
Enumeration date
01/04/2007
Last updated
12/21/2023
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