Individual
JENNY LIN THERIAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3516 E 10TH ST, JEFFERSONVILLE, IN 47130-9315
(812) 704-3288
Mailing address
3516 E 10TH ST, JEFFERSONVILLE, IN 47130-9315
(812) 704-3288
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28266113A
IN
Other
Enumeration date
07/29/2024
Last updated
08/04/2024
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