Individual
JACLYNE A BUZZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2500 W MARKET ST, LOUISVILLE, KY 40212-1541
(502) 778-8400
(502) 996-8309
Mailing address
PO BOX 950244, LOUISVILLE, KY 40295-0244
(502) 953-4700
(502) 772-8189
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3007767
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100245250
—
KY
01
—
P00613332
RAILROAD MEDICARE PIN
—
Enumeration date
12/21/2007
Last updated
10/18/2023
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