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Individual

ALICESON JO MARIE STROUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, NP-C

Contact information

Practice address
160 N EAGLE CREEK DR STE 302, LEXINGTON, KY 40509-2124
(859) 867-5044
(859) 967-5041
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7835

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007508
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100223160
KY
01
K052803
MEDICARE
KY
Enumeration date
07/11/2012
Last updated
03/07/2024
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