Individual
MS. JERI HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-7001
(859) 257-1000
Mailing address
740 S LIMESTONE L543, LEXINGTON, KY 40536-7001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2353
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003114915T
—
GA
05
—
167412
—
AL
Enumeration date
06/24/2011
Last updated
12/09/2020
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