Individual
JEFFREY PRATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
110 HELM ST, ELIZABETHTOWN, KY 42701
(270) 312-3861
Mailing address
10101 LINN STATION RD STE 600, LOUISVILLE, KY 40223-3818
(502) 589-8600
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3007768
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71003451A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71003451A
INDIANA LIC
IN
Enumeration date
03/07/2007
Last updated
03/06/2024
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