Individual
JERELEN DECHATELET HANCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2000
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 344-5555
(859) 344-5552
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3003125
KY
363LF0000X
Family Nurse Practitioner
3003125
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100143200
—
KY
Enumeration date
01/11/2008
Last updated
01/12/2011
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