Individual
JESSICA ECKHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
12204 SHELBYVILLE RD, LOUISVILLE, KY 40243-1450
(502) 200-5228
(502) 200-5249
Mailing address
17113 MALLET HILL DR, LOUISVILLE, KY 40245-4476
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3011501
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K365280
—
KY
Enumeration date
06/16/2014
Last updated
10/06/2022
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