Individual
MRS. JESSICA LAYNE BODENHAMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA, DNP
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536
(859) 323-5956
(859) 323-1080
Mailing address
800 ROSE ST, LEXINGTON, KY 40536-0293
(859) 218-0064
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
118309
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
3012474
KY
Other
Enumeration date
06/20/2018
Last updated
07/12/2018
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