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Individual

KAYLA JORDAN PRIDEMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
61 CROSBY DRIVE, JENKINS, KY 41537
(606) 872-1745
Mailing address
PO BOX 90, PINE TOP, KY 41843-0090

Taxonomy

Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
Primary
1141181
KY

Other

Enumeration date
12/12/2025
Last updated
12/12/2025
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