Individual
JESSICA MAE HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
100 MALLARD CREEK RD STE 300, LOUISVILLE, KY 40207-5136
(502) 855-6125
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3014011
KY
363LP2300X
Primary Care Nurse Practitioner
3014011
KY
Other
Enumeration date
12/12/2019
Last updated
03/13/2020
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