Individual
JEANETTA CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 MOHAWK ST, BROWNSVILLE, KY 42210-8556
(270) 901-5000
Mailing address
380 SUWANNEE TRAIL ST, BOWLING GREEN, KY 42103-7956
(270) 901-5000
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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